ESP Block for Postoperative Analgesia in URS Surgery

NCT ID: NCT06826833

Last Updated: 2026-02-19

Basic Information

• Recruitment Status: COMPLETED
• Clinical Phase: NA
• Total Enrollment: 70 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2025-02-20
• Study Completion Date: 2025-08-20

Brief Summary

The goal of this clinical trial is to determine whether the erector spinae plane (ESP) block provides better pain relief after flexible ureterorenoscopy (URS) surgery compared to standard analgesia alone. Researchers want to know:

Does the ESP block reduce pain levels in the first 24 hours after surgery?

Does it lower the need for opioid pain medication?

Does it reduce the need for additional (rescue) pain treatment?

Does it decrease the likelihood of postoperative nausea and vomiting (PONV)?

Participants will be randomly placed into one of two groups:

ESP Block Group: Participants will receive an ESP block using 20 mL of 0.25% bupivacaine under ultrasound guidance before surgery.

Control Group: Participants will receive standard pain management without a nerve block.

All participants will receive general anesthesia during surgery and multimodal pain management after surgery. Researchers will compare pain scores, opioid use, rescue analgesic needs, and the occurrence of nausea and vomiting between the two groups.

Detailed Description

Intervention Group (ESP Block): Patients will receive 20 mL of 0.25% bupivacaine (1:1 diluted with 0.5% bupivacaine) under ultrasound guidance at the T8-T10 level.

Control Group: No block will be performed, and patients will receive standard postoperative multimodal analgesia.

Procedure Description: The ESP block will be performed under sterile conditions with a high-frequency linear ultrasound probe. A 100-mm echogenic needle will be inserted in a cephalocaudal direction to deposit the local anesthetic deep to the erector spinae muscle at the transverse process level. The correct spread of the anesthetic will be confirmed via real-time ultrasound imaging.

All patients will receive standardized general anesthesia and multimodal analgesia.

Outcome measures include postoperative pain (NRS), opioid consumption, rescue analgesia requirement, and postoperative nausea and vomiting (PONV).

Conditions

Analgesia; Postoperative Pain Management; Nephrolithiasis

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: PARALLEL
• Primary Study Purpose: TREATMENT
• Blinding Strategy: SINGLE

Study Groups

ESP Block Group

A regional anesthesia technique in which 20 mL of 0.25% bupivacaine is injected under ultrasound guidance at the T8-T10 level to provide postoperative pain relief.

Group Type: EXPERIMENTAL

Erector Spinae Plane (ESP) Block

Intervention Type: PROCEDURE

A regional anesthesia technique in which 20 mL of 0.25% bupivacaine is injected under ultrasound guidance at the T8-T10 level to provide postoperative pain relief.

Control Group

Patients will receive routine multimodal analgesia without an ESP block.

Group Type: NO_INTERVENTION

No interventions assigned to this group

Interventions

Erector Spinae Plane (ESP) Block

A regional anesthesia technique in which 20 mL of 0.25% bupivacaine is injected under ultrasound guidance at the T8-T10 level to provide postoperative pain relief.

Intervention Type: PROCEDURE

Eligibility Criteria

Inclusion Criteria

Patients undergoing elective flexible ureterorenoscopy (URS).

Age: 18-65 years.

ASA I-II.

Willing to participate and provide written informed consent.

Exclusion Criteria

BMI >35 kg/m².

Allergy to local anesthetics.

Coagulation disorders or use of anticoagulants.

Patients requiring emergency surgery.

Patients with infection at the ESP block site.

• Minimum Eligible Age: 18 Years
• Maximum Eligible Age: 65 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Namik Kemal University

OTHER

Sponsor Role: lead

Responsible Party

Onur Baran

Asst. Prof.

Responsibility Role: PRINCIPAL_INVESTIGATOR

Principal Investigators

Ayhan Şahin, Assoc. Prof.

Role: PRINCIPAL_INVESTIGATOR

Namik Kemal University

Locations

Tekirdağ Namık Kemal University Research Hospital

Tekirdağ, , Turkey (Türkiye)

Countries

Turkey (Türkiye)

References

Forero M, Adhikary SD, Lopez H, Tsui C, Chin KJ. The Erector Spinae Plane Block: A Novel Analgesic Technique in Thoracic Neuropathic Pain. Reg Anesth Pain Med. 2016 Sep-Oct;41(5):621-7. doi: 10.1097/AAP.0000000000000451.

Reference Type: BACKGROUND

PMID: 27501016 (View on PubMed)

Bryniarski P, Bialka S, Kepinski M, Szelka-Urbanczyk A, Paradysz A, Misiolek H. Erector Spinae Plane Block for Perioperative Analgesia after Percutaneous Nephrolithotomy. Int J Environ Res Public Health. 2021 Mar 31;18(7):3625. doi: 10.3390/ijerph18073625.

Reference Type: BACKGROUND

PMID: 33807296 (View on PubMed)

Related Links

https://doi.org/10.1097/AAP.0000000000000451

Ref. 2

Other Identifiers

TNKU-URS001

Identifier Type: -

Identifier Source: org_study_id