Erector spinae plane block vs. Nonsteroidal anti-inflammatory drugs for severe renal colic pain: a pilot clinical feasibility study

Abstract

Aim: Ultrasound-guided plane blocks are increasingly used in the multi-modal analgesic concept for reducing opioid consumption. The present study was conducted to compare the analgesic effect of intravenous nonsteroidal anti-inflammatory drugs (NSAIDs) and erector spinae plane (ESP) block in renal colic patients. Methods: In this prospective randomized study, 40 patients with renal colic pain were randomly assigned to into two groups; Group NSAID (n=20) received an intravenous infusion of 50 mg of dexketoprofen trometamol, Group ESP (n=20) received ultrasound-guided erector spinae plane block with 30 ml 0.25% bupivacaine at the T8 level. The pain severity of patients was assessed using the visual analog scale (VAS) at baseline, 5., 15., 30., 45. and 60. minutes after intervention. Opioid consumption, patient satisfaction and side effects were recorded. Results: In the ESP group, the VAS scores were significantly lower than the NSAID group at 5., 15., 30., 45. and 60. minutes after the procedure (P<0.001). Opioid consumption was significantly higher in the NSAID group compared with the ESP group (10/20 vs. 0/20, respectively; p<0.001). Patient satisfaction was significantly higher in the ESP group (p<0.001). Conclusions: ESP block can be an alternative, efficient, and safe method for the relief of acute renal colic pain. a. What is already known about the topic: Non-steroidal anti-inflammatory drugs, systemic opioid analgesics, trigger point injections and other regional anesthetic methods were commonly used analgesic methods for renal colic pain. The effect of interfacial plane blocks is still limited. b. What new information this study adds: This is the first randomized controlled study to evaluate the use of erector spinae plane block for severe renal colic pain. Erector spinae plane block provides effective analgesia with opioid sparing effects for this indication.