HOW I DO IT

• How I Do It: ERAS protocol featuring erector spinae plane block for percutaneous nephrolithotomy

  Zhang Bertie, Ochuba J. Arinze, Mullen R. Gregory, Rai Arun, Aro Tareq, Hoenig M. David, Okeke Zeph, Winoker S. Jared The Smith Institute for Urology at Lenox Hill, Zucker School of Medicine at Hofstra/Northwell Health, New York, New York, USA

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  Percutaneous nephrolithotomy (PCNL) is the gold-standard treatment for large and complex renal stones. Though associated with higher stone-free rates compared to other minimally invasive stone procedures, this comes at the expense of increased morbidity including postoperative pain and discomfort. We describe our enhanced recovery after surgery (ERAS) protocol for PCNL with emphasis on the use of erector spinae plane blocks to improve patient satisfaction and reduce postoperative opioid use and bother.

  Keywords: regional anesthesia, PCNL, ERAS, multimodal pain control,

  Aug 2023 (Vol. 30, Issue 4 , Page 11639)
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• How I Do It: The pudendal nerve block for pediatric ambulatory urologic surgery

  Okoro Chinonyerem, Cannon Shannon, Low Daniel, Lendvay S. Thomas, MD Department of Urology, University of Washington Medical Center, Seattle, WA

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  Regional analgesia is an important adjunct for perioperative pain management in the setting of pediatric penile surgeries. Caudal epidural analgesia (CEA) is the most common analgesic technique performed, but it has limitations and associated morbidity. The pudendal nerve block (PNB) is an effective alternative to CEA with a lower risk profile; in prior examination of the approach, PNB has been demonstrated to have similar postoperative pain control outcomes. We describe our technique and highlight observations made as we have transitioned from CEA to PNB for many patients.

  Keywords: pudendal nerve block, regional anesthesia, pediatric urology, pain management,

  Apr 2021 (Vol. 28, Issue 2 , Page 10648)
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