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Thoracic Paravertebral Block for Renal Colic: A Case Report.

John J Finneran¹, Seth K Bechis², Brian M Ilfeld¹

¹From the Departments of Anesthesiology.

|September 10, 2020

Summary

Paravertebral blocks effectively managed severe renal colic pain unresponsive to opioids. This regional anesthesia technique provided rapid, complete pain relief for a patient with a ureteral stone.

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Area of Science:

Anesthesiology
Urology
Pain Management

Background:

Renal colic, often caused by ureteral stones, is a common cause of severe pain.
Current management typically involves analgesics, with limited reports on regional anesthesia techniques.
Opioid analgesia may be insufficient for severe renal colic pain.

Observation:

A 49-year-old male presented with severe left flank pain due to a 4-mm left ureteral stone.
Intravenous opioid administration provided minimal pain relief.
Left-sided paravertebral blocks were administered at the T7 and T9 levels using bupivacaine with epinephrine.

Findings:

The paravertebral blocks resulted in complete resolution of renal colic pain within 30 minutes.
The patient experienced no further pain and was discharged home.
Pain relief persisted throughout the stone passage process.

Implications:

Paravertebral blocks represent a viable and effective alternative for managing renal colic pain.
This regional anesthesia approach offers a potentially superior alternative to systemic opioids for severe renal colic.
Further research into paravertebral blocks for renal colic could optimize pain management strategies in urology.