Comparison of the effects of paravertebral nerve block combined with general anesthesia and general anesthesia on the early rehabilitation of patients undergoing percutaneous nephrolithotomy

Objective To compare the effects of paravertebral nerve block combined with general anesthesia and general anesthesia on the early recovery quality of patients undergoing percutaneous nephrolithotomy. Methods A total of 120 patients, ASA grades Ⅰ-Ⅱ, aged 20-70 years, and body mass index (BMI)<35 kg/m² who were scheduled for elective percutaneous nephrolithotomy were selected. They were randomly divided into two groups (n=60): a general anesthesia group (group G), and a paravertebral nerve block group combined with general anesthesia group (group GP). Group G received routine anesthesia, while group GP underwent paravertebral nerve block before anesthesia induction. The QoR-40 scale scores were recorded one day before surgery (D1), one day after surgery (D2), and two days after surgery (D3). The changes of heart rate (HR) and mean arterial pressure (MAP) in the two groups were recorded before anesthesia induction (T0), 10 min after anesthesia induction (T1), and at the beginning of stone removal were recorded (T2), 30 min after the beginning of stone removal (T3), at the end of surgery (T4), and 5 min after extubation (T5). The total dosage of propofol and remifentanil, postoperative analgesia remedy, and the Visual Analogue Score (VAS) 2 h, 6 h, 12 h, 24 h and 48 h after surgery were recorded. The incidence of postoperative nausea and vomiting, and postoperative bedtime, total expense, and discharge time were recorded. Results Compared with group G, group GP presented remarkable increases in the total score of QoR-40 on D2 and D3 (P<0.05), more stable HR and MAP at T2 and T5 (P<0.05), remarkable decreases in the total dosage of propofol and remifentanil (P<0.05), decreases in the incidence of postoperative analgesic remedy (P<0.05), decreases in the VAS score 2 h and 6 h after operation (P<0.05), decreases in the incidence of nausea and vomiting (P<0.05), with shorter bedtime, lower expense, and earlier discharge time (P<0.05). Conclusions Paravertebral nerve block combined with general anesthesia is superior to general anesthesia in the early rehabilitation of patients undergoing percutaneous nephrolithotomy.