الفهرس 
AcknowledgementOnly 14 pages are availabe for public view
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Abstract
Renal surgeries (RS) are usually associated with significant postoperative pain. Postoperative analgesia following RS is essential to allow effective coughing, early mobilization, and to reduce the incidence of postoperative respiratory complications. A considerable portion of those patients may suffer from comorbidities, such as impaired renal function, hypertension, and ischemic heart diseases. So morbidity rates can be reduced by sufficient pain relief. [119]
Varieties of techniques for postoperative analgesia following RS were applied. Administration of systemic analgesia after RS may be precluded by impaired renal function and respiratory complications from the use of opioids.[3] Other techniques include intramuscular and/or intravenous injection of parcetamol or non-steroidal anti‑inflammatory drugs. However, none of these methods was proven to be highly effective. [1, 2]
On the other hand, postoperative analgesia by utilizing epidural blockade demonstrated high rates of safety and efficacy in upper abdominal surgery, including renal surgery but with some minor drawbacks and reported hypotensive events.[106]
An emerging alternative to epidural analgesia in abdominal surgery is the use of ultrasound guided paravertebral catheters [126]. Recent studies have shown that paravertebral catheters can provide fewer side effects when compared to epidurals [127, 128]. Additionally, studies also showed that paravertebral blocks have less hypotension than epidurals. Along with a low side-effect profile and fewer contraindications, paravertebral catheters can be performed under real time ultrasound guidance, which may increase the success rate of placement. [129, 130]
PVB has not been extensively studied as analgesic tool in renal surgery. Therefore, in the current study we have conducted a prospective randomized trial aiming at the assessment of the respiratory and analgesic effects of continuous thoracic paravertebral block versus thoracic epidural in patients undergoing renal surgeries for different purposes.