Ultrasound-guided erector spinae plane block versus retrolaminar block in patients undergoing percutaneous nephrolithotomy: a randomized prospective noninferiority study

Abstract

Background Percutaneous nephrolithotomy (PCNL) is currently the recommended technique for the management of renal calculi. While erector spinae plane block (ESPB) and retrolaminar block (RLB) have a similar block site, they may work on different analgesic principles. Though these blocks are quicker, safer, and easier to administer, very few studies have been done to compare their postoperative analgesic efficacy. Objective The current study compared the effects of ultrasound (US)-guided ESPB versus RLB on intraoperative and postoperative analgesia in patients undergoing PCNL to identify a safe and effective regional block technique. Patients The study was conducted on 120 patients divided into two groups: group I, including 60 patients who received US-guided ESPB, and group II, including 60 patients who received US-guided RLB. Results The results showed an insignificant difference between the two groups regarding hemodynamic data, visual analog scale, additional analgesic requirements, and the amount consumed. Regarding postoperative complications, the incidence of both nausea and vomiting was found to be similar in the two groups, which were matched regarding the number of patients with nausea and vomiting; the number was less than 10 patients in each group. The time to ambulation and readiness for discharge showed an insignificant difference between the two studied groups. The majority of the patients in the two groups were satisfied. Conclusion US-guided RLB is not inferior to ESPB in providing safe and effective analgesia in patients undergoing PCNL.