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Erector spinae plane block versus paravertebral block and placebo for recovery quality after percutaneous nephrolithotomy: A randomized controlled trial
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Erector spinae plane block versus paravertebral block and placebo for recovery quality after percutaneous nephrolithotomy: A randomized controlled trial
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Erector spinae plane block versus paravertebral block and placebo for recovery quality after percutaneous nephrolithotomy: A randomized controlled trial
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Journal Article
Erector spinae plane block versus paravertebral block and placebo for recovery quality after percutaneous nephrolithotomy: A randomized controlled trial
2026
Overview
To compare recovery quality after PCNL using ESPB, TPVB, and placebo.
Randomized, double-blind, placebo-controlled trial.
Sanming First Hospital affiliated to Fujian Medical University in China.
120 adults with American Society of Anesthesiologists physical status I–II scheduled for elective unilateral PCNL.
Patients were randomized 1:1:1 to receive ESPB, TPVB, or placebo to test ESPB superiority over placebo and non-inferiority to TPVB.
The primary outcome was Quality of Recovery-15 (QoR-15) score at 24 h. We tested ESPB superiority over placebo (8-point clinically important difference) and non-inferiority to TPVB (6-point margin). Secondary outcomes included pain scores, morphine consumption, time to first rescue analgesia, patient satisfaction, and adverse events.
ESPB demonstrated significantly higher QoR-15 scores than placebo (median difference 11.0 points, 95% CI 7.0–14.0, P < 0.001) and met non-inferiority criteria versus TPVB (median difference 1.0 point, 95% CI −5.0 to 2.0). Both blocks reduced pain scores and morphine consumption by approximately 40% compared with placebo (P < 0.001), with no differences between techniques. Time to first rescue analgesia was prolonged with both blocks compared with placebo (P < 0.001). Patient satisfaction was higher with both blocks than with placebo (P < 0.001). No block-related complications occurred; postoperative adverse events were similar across groups.
ESPB significantly improved recovery quality after PCNL, demonstrating superiority to placebo and non-inferiority to TPVB. ESPB represents an effective alternative to TPVB for PCNL analgesia, with comparable efficacy and safety.
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•ESPB demonstrated non-inferiority to TPVB for recovery quality after percutaneous nephrolithotomy.•Both regional blocks reduced pain scores and opioid consumption by approximately 40 % versus placebo.•Time to first rescue analgesia was prolonged four-fold with regional blocks compared with placebo.•No block-related complications occurred with either ESPB or TPVB.
Publisher
Elsevier Inc,Elsevier Limited
Subject
/ Aged
/ Analgesics, Opioid - administration & dosage
/ Female
/ Humans
/ Male
/ Morphine
/ Morphine - administration & dosage
/ Nausea
/ Nephrolithotomy, Percutaneous - adverse effects
/ Nephrolithotomy, Percutaneous - methods
/ Nerve Block - adverse effects
/ Paraspinal Muscles - innervation
/ Percutaneous nephrolithotomy
/ Postoperative Pain - diagnosis
/ Postoperative Pain - etiology
/ Postoperative Pain - prevention & control
/ Vomiting
