الفهرس 
Anatomical Considerations of the kidneysOnly 14 pages are availabe for public view
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Abstract
Percutaneous nephrolithotomy (PCNL) is now the gold standard for
treatment of patients with large and complex renal calculi as it is less invasive
than open surgery and is generally associated with less complications and
faster recovery; however, the postoperative pain, which is mostly due to
dilatation of the renal capsule and the parenchymal tract, in addition to
peritubal compression of the nephrostomy tube, requires analgesic agents to
control this pain.
Appropriate pain treatment aims to improve the results of the surgery,
reduce postoperative morbidity, decrease the incidence of chronic
postsurgical pain and decrease the duration of hospital stay.
Treatment of postoperative pain after PCNL is based on conventional
drugs for pain relief (large doses of paracetamol, NSAID, and oral or
intravenous opioid). This is associated with adverse effects, such as nausea,
sedation, hypotension and increased cardiac load. All these effects delay
rehabilitation, overall recovery and discharge.
Here the role of the regional block appears to overcome these side
effects for the management of acute postoperative pain in PCNL. Recently,
ultrasound-guided technique regional block has been used successfully to
avoid the problems of the blind technique and provided better control of a
variety of postoperative pain.
The erector spinae plane (ESP) block is a safe, simple and effective
regional anaesthesia technique that can be used to provide analgesia for
PCNL and other surgical procedures.
The aim of our study was to evaluate the efficacy of the ultrasoundguided erector spinae plane block as a postoperative analgesia in elective
unilateral percutaneous nephrolithotomy (PCNL).
This study was conducted on 42 patients aged between 18 and 60
years old, ASA physical status I_II who were scheduled for elective
unilateral PCNL. Patients were randomized into two groups, 21 Patients in
each group.
group C: (Control group)
Patients received only general anesthesia & 20 ml of normal saline.
group E: (Erector spinae plane block group)
Patients received US-guided ESP block with 20 ml of 0.25%
bupivacaine after general anaesthesia.