AUA 2017: Paravertebral Block for Percutaneous Nephrolithotomy: A Prospective, Randomized, Double-Blind Placebo-Controlled Study

Boston, MA ( Dr. Baldea and a group of urologists and anesthesiologists from Loyola University in Chicago conducted a clinical trial to investigate the efficacy of paravertebral block (PVB) for percutaneous nephrolithotomy (PCNL). The primary objective in this study was to compare subjective and objective pain outcomes with a fentanyl PVB.

Visual analog pain scores decreased from 3 to 2.7 to 2 at 12- and 24-hours postoperatively. In addition, the total intravenous morphine equivalent dose and PCA pump demand was approximately 13% lower in the PVB group. Furthermore, significant differences (p < 0.001) were found for time to first analgesic administration (120 vs. 20 minutes, PVB and placebo, respectively) and rate of supplemental PO narcotic use (30 vs. 62%, PVB and placebo, respectively). Interestingly, there was a near 20% in the amount of anti-emetics required for the PVB group.

Following the presentation, Dr. Baldea commented that a majority of PCNLs were performed with lower pole access and there was no significant difference in pain outcomes with respect to variable access sites. In addition, a single anesthesiologist supervised and performed a majority (>80%) of the PVBs; however, PVB experience is an important consideration if it is to be utilized for PCNL.

Presented By: Dr. Kristin G. Baldea, MD

Author(s): Kristin G. Baldea, Grace Delos Santos, Chandy Elilimoottil, Ahmer Farooq, Elizabeth R. Mueller, Scott Byram, Thomas M.T. Turk

Affiliation: Loyola University, Chicago, IL University of Michigan, Ann Arbor, MI

Written By: Daniel Lama for

at the 2017 AUA Annual Meeting - May 12 - 16, 2017 – Boston, Massachusetts, USA