Ultrasound-Guided Subtransverse Interligamentary Block Versus Thoracic Paravertebral Block for Postoperative Analgesia in Patients Undergoing Open Nephrectomy

Ultrasound-Guided Subtransverse Interligamentary Block Versus Thoracic Paravertebral Block for Postoperative Analgesia in Patients Undergoing Open Nephrectomy: A Randomized Clinical Trial

This study aims to compare ultrasound-guided subtransverse process interligamentary (STIL) block versus thoracic paravertebral block (TPVB) for postoperative analgesia in patients undergoing open nephrectomy.

Acute pain physiopathology is explained as it is mediated by inflammatory cell infiltration, activation of spinal cord pain pathways, and also by reflexive muscle spasm. All of these three mechanisms of acute pain are typically ameliorated during the postoperative recovery.

A thoracic paravertebral block (TPVB) shows comparable analgesic efficacy with fewer side effects compared with thoracic epidural analgesia in patients undergoing thoracotomy.

The recently introduced subtransverse process interligamentary (STIL) block offers a safer alternative by targeting thoracic nerves without entering paravertebral space.

Inclusion Criteria:

• Age from 18 to 65 years.
• Both sexes.
• American Society of Anesthesiology (ASA) physical status I-III.
• Undergoing open nephrectomy under general anesthesia.

Exclusion Criteria:

• History of allergies to local anesthetics.
• Opioid dependency.
• Bleeding or coagulation disorders.
• Psychiatric and neurological disorder.
• Local infection at the site of injection.
• Body mass index (BMI) > 35 kg/m2.
• Severe heart, lung, liver, and renal dysfunction.
• Pregnant or lactating women.