Comparison of the effects of ultrasonography-guided erector spina plane block and intramuscular nonsteroidal anti-inflammatory drug (NSAID) administration methods on intraoperative analgesia and patient satisfaction in extracorporeal shock wave lithotripsy (ESWL) operations

Aim: In this study, it was aimed to compare the effects of ultrasonography-guided erector spina plane block (ESPB) and intramuscular nonsteroidal anti-inflammatory drug (NSAID) administration methods on intraoperative analgesia, hemodynamic parameters and patient satisfaction in Extracorporeal Shock Wave Lithotripsy (ESWL) operations. Materials and Methods: The study The study was conducted between 31.10.2022-26.04.2023, in the Stone Breaking Unit of the Urology Clinic of the Harran University Medical Faculty Hospital, with a total of 90 cases consisting of 3 groups. The 1st group was given an erector spina plane block with ultrasonography, and the 2nd group was given intramuscular nonsteroidal anti-inflammatory drug (NSAID) before administration. The third group was not given any analgesic and was processed directly. VAS (visual analog scale) was used to evaluate patients' pain during ESWL ischemia. Hemodynamic parameters (noninvasive systolic-diastolic and mean arterial pressure, heart rate, oxygen saturation) were recorded every 5 minutes during the ESWL procedure. Side effects (bradycardia, hypertension, nausea-vomiting, hypotension, delirium, arrhythmia, drowsiness, itching, dizziness, blurred or double vision) were recorded throughout the procedure. After the procedure, the patients' analgesic needs and patient satisfaction were evaluated. Results: All data of 90 cases included in the study were analyzed. There is no statistically significant difference in the age, gender, ASA score, BMI measurement, smoking history, patient satisfaction, ESWL duration, HR, MAP and SpO2 values of the patients. When VAS measurements were evaluated, the 25th minute intraoperative VAS measurements of the subjects in the ESPB group in the first 25 minutes were significantly lower than those in the NSAID and control groups. The rate of needing postoperative analgesics at the beginning of the subjects in the control group was significantly higher than those in the ESP and NSAID groups (p=0.016; p<0.05). When patient satisfaction is analyzed according to the groups; satisfaction level of the control group was significantly lower than the ESP and NSAID groups (p=0.018; p<0.05). There was no significant difference between the groups in the evaluation of side effects. Conclusion: When the data obtained and patient satisfaction were evaluated, it was observed that ESPB is an effective procedure in the treatment of kidney stones in the relief of pain during the ESWL procedure. Keywords: Analgesia, ESWL, Kidney stone, ESPB