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<p>We aimed to determine the postoperative gastrointestinal tract dysfunction and intraoperative hemodynamic effects of ultrasound-guided retrolaminar block in patients undergoing percutaneous nephrolithotomy. Fifty-eight adult patients were randomly divided into 2 groups preoperatively: Group RLB (<i>n</i> = 28) underwent ultrasound-guided retrolaminar block with 20 mL 0.5% bupivacaine. Group Control (<i>n</i> = 30) patients without block application. Primary outcome measure was abdominal Perlas score by ultrasound. Secondary outcome measures were time to first oral feeding, flatus, defecation, mobilization; duration of hospital stay; I-FEED (intake, feeling nauseated, emesis, physical examination, duration of symptoms) Score values; Patient Satisfaction Score; duration of postoperative rescue analgesia; Visual Analog Scale scores; intraoperative heart rate and mean arterial pressures. Patients in Group RLB exhibited significantly lower intraoperative opioid consumption (61.11 ± 21.18&#xa0;µg, <i>p</i> &lt; 0.001) and a prolonged time to rescue analgesia (13.35 ± 4.06&#xa0;min). VAS scores were consistently lower postoperatively, and patient satisfaction was high. Additionally, the Group RLB demonstrated reduced gastric content volume at 6&#xa0;h postoperatively (<i>p</i> = 0.004) and a lower I-FEED score (2.35 ± 0.91, <i>p</i> &lt; 0.05), indicating improved gastrointestinal function. Heart rate and mean arterial pressure were also significantly reduced in Group RLB. Retrolaminar block has shown positive effects on postoperative pain management, gastrointestinal tract function and hemodynamic stability in PCNL. Lower opioid consumption, faster bowel movements and longer-lasting analgesic effect improved patient satisfaction and provided adequate postoperative pain control. These findings support the use of RLB as a safe and effective analgesic method in PCNL surgery.</p>

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Ultrasound guided retrolaminar block reduces postoperative gastrointestinal system dysfunctions during percutaneous nephrolithotomy: a prospective, randomised, double-blind, clinical study

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  • 发表日期：

    2025年9月30日

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  • Serpil Bayindir,
  • Kadir Yildirim

摘要

We aimed to determine the postoperative gastrointestinal tract dysfunction and intraoperative hemodynamic effects of ultrasound-guided retrolaminar block in patients undergoing percutaneous nephrolithotomy. Fifty-eight adult patients were randomly divided into 2 groups preoperatively: Group RLB (n = 28) underwent ultrasound-guided retrolaminar block with 20 mL 0.5% bupivacaine. Group Control (n = 30) patients without block application. Primary outcome measure was abdominal Perlas score by ultrasound. Secondary outcome measures were time to first oral feeding, flatus, defecation, mobilization; duration of hospital stay; I-FEED (intake, feeling nauseated, emesis, physical examination, duration of symptoms) Score values; Patient Satisfaction Score; duration of postoperative rescue analgesia; Visual Analog Scale scores; intraoperative heart rate and mean arterial pressures. Patients in Group RLB exhibited significantly lower intraoperative opioid consumption (61.11 ± 21.18 µg, p < 0.001) and a prolonged time to rescue analgesia (13.35 ± 4.06 min). VAS scores were consistently lower postoperatively, and patient satisfaction was high. Additionally, the Group RLB demonstrated reduced gastric content volume at 6 h postoperatively (p = 0.004) and a lower I-FEED score (2.35 ± 0.91, p < 0.05), indicating improved gastrointestinal function. Heart rate and mean arterial pressure were also significantly reduced in Group RLB. Retrolaminar block has shown positive effects on postoperative pain management, gastrointestinal tract function and hemodynamic stability in PCNL. Lower opioid consumption, faster bowel movements and longer-lasting analgesic effect improved patient satisfaction and provided adequate postoperative pain control. These findings support the use of RLB as a safe and effective analgesic method in PCNL surgery.