How I Do It: ERAS protocol featuring erector spinae plane block for percutaneous nephrolithotomy.

Area of Science:

• Urology
• Anesthesiology
• Surgical Recovery

Background:

• Percutaneous nephrolithotomy (PCNL) is the standard treatment for large renal stones.
• PCNL offers high stone-free rates but is associated with significant postoperative pain and discomfort.
• Enhanced recovery after surgery (ERAS) protocols aim to optimize patient outcomes and reduce recovery time.

Purpose of the Study:

• To describe an enhanced recovery after surgery (ERAS) protocol for percutaneous nephrolithotomy (PCNL).
• To evaluate the effectiveness of erector spinae plane (ESP) blocks within the ERAS protocol.
• To assess the impact of the protocol on patient satisfaction, postoperative opioid consumption, and pain.

Main Methods:

• Implementation of a comprehensive ERAS protocol for PCNL patients.
• Inclusion of erector spinae plane (ESP) blocks as a key component for postoperative analgesia.
• Standardized pain management, early mobilization, and nutritional support strategies.

Main Results:

• The ERAS protocol, incorporating ESP blocks, was successfully implemented.
• Preliminary data suggest improved patient satisfaction.
• Reduced postoperative opioid use and patient-reported bother were observed.

Conclusions:

• An enhanced recovery after surgery (ERAS) protocol can effectively manage postoperative recovery after percutaneous nephrolithotomy (PCNL).
• Erector spinae plane (ESP) blocks are a valuable tool in multimodal analgesia for PCNL.
• This approach enhances patient satisfaction and reduces opioid requirements.