Abstract: Paravertebral block has been successfully used for anesthesia management in percutaneous nephrolithotomy for renal and upper ureteral stones.We report a case of paravertebral block applied for anesthesia in a high-risk elderly patient with multiple comorbidities undergoing flexible ureteroscopic lithotripsy for upper ureteral stone on the right side.Two weeks prior to the surgery,a ureteral stent was placed for preoperative ureteral dilation.On the day of the procedure,ultrasound-guided multi-level (T8-9-10-11-12) paravertebral blocks were performed.The surgeon selected a small-diameter ureteral access sheath,and topical urethral anesthesia was additionally administered.A low dose of oxycodone was administered intravenously during the surgery for supplemental analgesia.The procedure was completed successfully.The patient was able to ambulate independently immediately after the surgery and was discharged two days postoperatively with an uneventful recovery.

Key words: paravertebral block; upper ureteral stone; flexible ureteroscopic lithotripsy