A Comparative Study Between the Use of Usg Guided Errector Spinae Block and USG Guided Paravetebral Block for Urological Surgeries

Background: Urological surgeries are often associated with moderate to severe postoperative pain due to extensive manipulation of abdominal and retroperitoneal structures. Effective perioperative analgesia is essential for enhanced recovery, improved pulmonary function, early mobilization, and reduced opioid consumption. Ultrasound-guided regional anesthesia techniques such as erector spinae block (ESB) and paravertebral block (PVB) have emerged as promising modalities. However, limited evidence exists comparing their efficacy in urological surgeries. Aim: To compare the analgesic efficacy and safety of USG-guided erector spinae block and paravertebral block in patients undergoing urological surgeries. Materials and Methods: This prospective, randomized, controlled study was conducted on 94 patients scheduled for elective urological surgeries under general anesthesia. Patients were randomly allocated into two groups: Group A (n=47) received USG-guided erector spinae block, while Group B (n=47) received USG-guided paravertebral block. All patients received intra-operative fentanyl (2 µg/kg). Postoperative pain scores, requirement of rescue analgesia, time to first rescue analgesia, hemodynamic stability, and complications were recorded. Statistical analysis was performed with significance set at p<0.05. Results: The demographic profiles were comparable between groups. Rescue analgesia was significantly lower in Group A (34.04%) compared to Group B (82.98%) (p<0.0001). The mean time to first rescue drug was longer in Group A (281.25 ± 323.27 min) than Group B (158.46 ± 119.79 min, p=0.036). Requirement of second rescue analgesia was lower in Group A (6.38%) compared to Group B (27.66%, p=0.012). Only a small proportion required a third dose (2.13% vs. 4.26%, p=1.000). No major block-related complications were reported. Conclusion: Both USG-guided erector spinae and paravertebral blocks provided effective analgesia in urological surgeries. However, erector spinae block demonstrated superior postoperative pain control, delayed requirement of rescue analgesia, and reduced opioid consumption compared to paravertebral block. Thus, ESB may be considered a safer and more effective alternative for perioperative analgesia in urological surgeries