Successful Percutaneous Nephrolithotomy Using Thoracic Paravertebral Block as the Sole Surgical Anesthesia: Cases Report

In general, percutaneouse nepholithotomy (PCNL) is usually done under general anesthesia or occasional epidural anesthesia. We reported three renal calculi cases, who had successful PCNL surgery using ultrasound-guided multiple injections for thoracic paravertebral block at the T8, T10, and T12 levels with 20 milliliter of 0.5% levobupivacaine for renal surgery on a unilateral side. Sensory blockade was evaluated at 30 minutes using pinprick sensation before starting the operation. Sensory blockade on the unilateral side from level T8 to L1 was achieved in all patients. During the procedure, dexmedetomidine infusion at 0.2 to 0.6 microgram per kilogram per hour was administered for patient sedation. All three cases reported no pain in the recovery room and mild pain on the first and second postoperative visits. There was no complication from both multiple thoracic paravertebral injections and PCNL surgery.