Effect of ultrasound-guided intercostal nerve block on postoperative pain after percutaneous nephrolithotomy Prospective randomized controlled study

Background. The aim of the study was to investigate the effect of preoperative ultrasound-guided (US) intercostal nerve block (ICNB) in the 11th and 12th intercostal spaces on postoperative pain control and tramadol consumption in patients undergoing percutaneous nephrolithotomy (PCNL). Methods. After obtaining ethical committee approval and written informed patient consent, 40 patients were randomly allocated to the ICNB group or the control group. For the ICNB group US-guided ICNB was performed with 0.5% bupivacaine and 1/200,000 epinephrine at the 11th and 12th intercostal spaces after premedication. A sham block was performed for the control group and postoperative pain and tramadol consumption were recorded by anesthesiologists blinded to the treatment. Results. Postoperative visual analog scale scores at all follow-up times were found to be significantly lower in the ICNB group than in the control group (p<0.05). The mean 24 h intravenous tramadol consumption was 97.5 +/- 39.5 mg for the ICNB group which was significantly lower than the 199.7 +/- 77.6 mg recorded for the control group (p<0.05). Conclusion. In PCNL with nephrostomy tube placement US-guided ICNB performed at the 11th and 12th intercostal spaces provided effective analgesia.