Theeffects of ultrasound guided thoracic paravertebralblock on hemodynamics and postoperativeanalgesia in percutaneous nephrolithotomy operations in children

Aim: In this study; planned percutaneous nephrolithotomy due to kidney Stone surgery in pediatric patients, ultrasound guided thoracic paravertebral block with bupivacaine on perioperative anaesthetic agent consumption and it was planned to investigate the efficacy of on postoperative analgesia. Material-Method: This study was performed after approval of Ethics Committee and parents written consent. Between the ages 1-5, planned percutaneous nephrolithotomy due to kidney stones 40 patients were enrolled in this study, and patients were randomly divided in to two group. All patients were performed general anaesthesia. The Group I patients was given ultrasound guided thoracic paravertebral block with 0.5 ml/kg bupivacaine %0.5 after giving prone position and the Group II patients was given 15 mg/kg of paracetamol as postoperative analgesia. In the period of postoperative, if the FLACC>4; it was planned to dose 1 mg/kg of tramadol. Pateints' hemodynamical parametres, oxygen saturation, sevoflurane concentration were recorded 10, 15, 30 and 60 minutes intraoperatively. Pateints' hemodynamical parametres, oxygensaturation, painscores (FLACC), satisfaction of parents, the number of patiens who additional analgesic requirements and side effects (nausea, vomiting, hypotension, bradycardia, respiration problems, etc) were recorded in the postoperative period. Result: Demographic characteristics, operation times, hemodynamical parametres of these groups were similar. Intraoperative sevoflurane concentrations were found significantlyless in Group I than Group II (p=0,000). While there were no patients need of analgesia in Group I, it was determined as 18 (%90) in Group II. While the number of patients evaluating as perfector good was high in Group I, the number of parents evaluating as good or bad was high in Group II. The rate of postoperative FLACC was determined as statistically significant less in Group I than Group II (p=0,000). None of the patients were hypotension, bradycardia or respiratory depression observed. Conclusion: In pediatric patients that the applied ultrasound guided thoracic paravertebral block according to systemic analgesia was decided less the need for perioperative anaesthetic agents and the additional analgesic requirements reduced and increases satisfaction of parents. Keywords: Ultrasound guided thoracic paravertebral block, percutaneous nephrolithotomy, children.