Paravertebral block against intercostal nerve block for postoperative pain relief in open renal surgery: a randomized controlled trial

Background Renal surgeries are usually associated with significant postoperative pain. Ineffective postoperative pain management may result in clinical and psychological changes that increase morbidity and mortality. In the current study, intercostal nerve block ( ICB) and paravertebral block ( PVB) were compared with regard to their analgesic efficacy, hemodynamic stability, blood gasometric profile, and postoperative complication. Patients and methods After local Ethics Committee approval, 100 patients, aged between 20 and 60 years, American Society of Anesthesiologists ( ASA) physical status I or II, scheduled for elective open renal surgery were enrolled in this study. Patients were randomized into two groups to receive either ICB ( ICB group) with bupivacaine (0.5%; n = 50) or PVB ( PVB group) with bupivacaine (0.5%; n = 50). The postoperative visual analogue scale score for pain, patients’ satisfaction score, and the need for analgesia were evaluated. Results The mean postoperative visual analogue scale scores demonstrated signifi cant decrease in the PVB group compared with the ICB group during quite and motion states (P 0.05). Patient satisfaction was greater in the PVB group than in the ICB group (P 0.0001). The mean time elapsed before the first request for analgesia in the PVB group was 17.37 ± 2.70 h, whereas patients in the ICB group started to request for analgesia after 8.96 ± 1.88 h (P 0.0001). The total analgesic consumption (meperidine) at 24 h postoperatively showed a signifi cant decrease in the PVB group compared with the ICB group (P 0.05). Conclusion PVB and ICB are safe analgesic techniques, and they decrease the postoperative pain score and analgesic requirements after open renal surgery. PVB provides more patient satisfaction and a longer duration of analgesia postoperatively.