Erector Spinae Plane Block vs Nephrostomy Tract Infiltration for Post-PCNL Analgesia

To compare the need for postoperative rescue analgesia in patients receiving an erector spinae plane block (ESPB) vs NTI (nephrostomy tract infiltration) following percutaneous nephrolithotomy (PCNL).

This randomized controlled trial was conducted in the Urology Department at tertiary care hospital, from August 29, 2023, to March 14, 2024. Sixty patients aged 18-80 years, scheduled for PCNL for renal stones >1.5 cm, were enrolled. Clinical symptoms and CT KUB findings confirmed eligibility. Patients were randomized into ESPB or NTI groups using the SNOSE technique. Pain was assessed using the Visual Analogue Scale at 6, 12, and 24 hours postoperatively. The need for rescue analgesia was recorded in both groups.

The mean age was 57.9 ± 5.45 years, with 63.3% male participants. The average operation duration was 2.05 ± 0.37 hours. Overall, 25% of patients required rescue analgesia. A significantly higher proportion of patients in the NTI group (40%) required rescue analgesia compared to the ESPB group (10%) (p = 0.007).

ESPB was more effective than NTI in reducing the requirement for postoperative rescue analgesia in patients undergoing PCNL.