Artikel ; Online: Erector spinae plane block with catheter for management of percutaneous nephrolithotomy: A three case report.
2020 Band 99, Heft 40, Seite(n) e22477
Abstract: Introduction: Percutaneous nephrolithotomy is a procedure used for management of refractory renal calculi. Oral and parenteral opioids, along with local anesthetic infiltration, neuraxial anesthesia, and paravertebral blocks are the most common methods ... ...
Abstract | Introduction: Percutaneous nephrolithotomy is a procedure used for management of refractory renal calculi. Oral and parenteral opioids, along with local anesthetic infiltration, neuraxial anesthesia, and paravertebral blocks are the most common methods of managing intra-operative and post-operative pain for these patients. The erector spinae plane block with catheter (ESPC) is a newer interfascial regional anesthetic technique that can be used to manage peri-operative pain in these patients. Clinical findings: Three patients complained of significant flank pain were scheduled for percutaneous nephrolithotomy under general anesthesia in the prone position. Diagnoses: Patients were diagnosed with large renal calculi. Therapeutic interventions: Patients received ESPC in the pre-operative holding area at the level of the T7 transverse process. The ESPCS were bolused with a solution of 30 mL 0.25% bupivacaine with 4 mg dexamethasone prior to surgery. Patients also received oral tramadol 50 mg and acetaminophen 1 g as part of the multimodal pain protocol prior to surgery. After the procedure, the patients were bolused with 0.25% bupivacaine or started on an infusion of 0.25% bupivacaine to manage their pain. Outcomes: No opioid or other pain medications, other than the local anesthetic solution given in the ESPCs, were used during the intra-operative or post-operative period for management of pain in these patients. Visual analogue scale (VAS) scores were below 4 for all patients in the post-operative period, and patients did not report any issues with post-operative nausea or vomiting. Conclusion: These patients were compared to 3 prior patients who had undergone percutaneous nephrolithotomy without ESPC. The 3 patients without ESPC placement reported increased VAS scores, had increased opioid/pain medication consumption intraoperatively and postoperatively, and had increased incidence of perioperative nausea when compared to our ESPC patients. Our report shows that ESPC, in combination with a multimodal pain protocol, can be a good option for management of patients undergoing percutaneous nephrolithotomy. |
---|---|
Mesh-Begriff(e) | Aged ; Anesthetics, Local/therapeutic use ; Bupivacaine/therapeutic use ; Dexamethasone/therapeutic use ; Female ; Humans ; Kidney Calculi/surgery ; Middle Aged ; Nephrolithotomy, Percutaneous/methods ; Nerve Block/methods ; Pain, Postoperative/prevention & control ; Paraspinal Muscles |
Chemische Substanzen | Anesthetics, Local ; Dexamethasone (7S5I7G3JQL) ; Bupivacaine (Y8335394RO) |
Sprache | Englisch |
Erscheinungsdatum | 2020-10-23 |
Erscheinungsland | United States |
Dokumenttyp | Case Reports ; Journal Article |
ZDB-ID | 80184-7 |
ISSN | 1536-5964 ; 0025-7974 |
ISSN (online) | 1536-5964 |
ISSN | 0025-7974 |
DOI | 10.1097/MD.0000000000022477 |
Datenquelle | MEDical Literature Analysis and Retrieval System OnLINE |
Zusatzmaterialien
Kategorien
Verfügbar in ZB MED Köln/Königswinter
Ua VI Zs.171: Hefte anzeigen | Standort: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 2021: Bestellungen von Artikeln über das Online-Bestellformular ab Jg. 2022: Lesesaal (EG) |
Über subito bestellen
Dieser Service ist kostenpflichtig (siehe Lieferbedingungen von subito). Bestellungen, die einen Artikel nebst Supplementary Material umfassen, werden grundsätzlich wie mehrfache Bestellungen bearbeitet. Gebühren fallen in diesen Fällen für jede einzelne Bestellung an.