The analgesic efficacy of paravertebral block for percutaneous nephrolithotomy: A meta-analysis of randomized controlled studies

Medicine (Baltimore). 2019 Nov;98(48):e17967. doi: 10.1097/MD.0000000000017967.

Abstract

Introduction: The analgesic efficacy of paravertebral block for percutaneous nephrolithotomy remains controversial. We conduct a systematic review and meta-analysis to explore the analgesic efficacy of paravertebral block for patients with percutaneous nephrolithotomy.

Methods: We have searched PubMed, EMbase, Web of science, EBSCO, and Cochrane library databases, and randomized controlled trials (RCTs) assessing analgesic efficacy of paravertebral block for percutaneous nephrolithotomy are included in this meta-analysis.

Results: Five RCTs are included in the meta-analysis. Overall, compared with control group after percutaneous nephrolithotomy, paravertebral block is associated with the decrease in analgesic consumption (standard mean difference (Std. MD) = -1.55; 95% confidence interval (CI) = -2.18 to -0.92; P < .00001) and additional analgesics (risk ratio (RR) = 0.17; 95% CI = 0.07 to 0.44; P = .0003), prolonged time to first analgesic requirement (Std. MD = 1.51; 95% CI = 0.26 to 2.76; P = .02). There is no statistical difference of adverse events including nausea or vomiting (RR = 0.51; 95% CI = 0.11 to 2.35; P = .38), or itching (RR = 0.69; 95% CI = 0.26 to 1.81; P = .45) between 2 groups.

Conclusions: Paravertebral block is effective for pain control after percutaneous nephrolithotomy.

Publication types

  • Meta-Analysis

MeSH terms

  • Adult
  • Analgesics / therapeutic use*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Nephrolithotomy, Percutaneous / adverse effects*
  • Nerve Block / statistics & numerical data*
  • Pain Management / methods
  • Pain Management / statistics & numerical data*
  • Pain, Postoperative / etiology
  • Pain, Postoperative / therapy*
  • Randomized Controlled Trials as Topic
  • Treatment Outcome

Substances

  • Analgesics