EFFECT OF ULTRASOUND-GUIDED ERECTOR SPINAE PLANE BLOCK ON POSTOPERATIVE PAIN IN PATIENTS UNDERGOING OPEN NEPHRECTOMY AND PYELOPLASTY: A SINGLE-CENTER OBSERVATIONAL STUDY

Abstract

Background: Effective postoperative pain control is important after open nephrectomy and pyeloplasty. Poor pain management can lead to complications and delayed recovery. The erector spinae plane (ESP) block is a newer regional anesthesia technique that may reduce pain and opioid use. Objective: To evaluate the analgesic efficacy of ultrasound-guided erector spinae plane block in patients undergoing open nephrectomy and pyeloplasty. Methods: This prospective observational study included 50 patients aged 18 years and above. All patients received an ultrasound-guided ESP block using 30 ml of 0.2% ropivacaine at the T10 level after surgery. Pain was assessed using the Numerical Rating Scale (NRS) at 0, 1, 2, 4, 8, 12, and 24 hours. Opioid consumption, time to first rescue analgesia, patient satisfaction, and hemodynamic parameters were recorded. Results: Most patients had no pain in the early postoperative period. At 24 hours, 80% of patients had no or mild pain. A total of 70% of patients did not require any opioid analgesic within 24 hours. Rescue analgesia was not required in 70% of patients, and when required, it was mostly after 12 hours. Patient satisfaction was good in 70% of patients. Hemodynamic parameters remained stable throughout the study period. Conclusion: Ultrasound-guided erector spinae plane block provides effective postoperative analgesia in patients undergoing open nephrectomy and pyeloplasty. It reduces pain scores, decreases opioid requirement, prolongs time to rescue analgesia, and maintains stable hemodynamics.