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Please confirm that an ethics committee approval has been applied for or granted: Yes: I’m uploading the Ethics Committee Approval as a PDF file with this abstract submissionApplication for ESRA Abstract PrizesBackground and Aims Perioperative pain management in Percutaneous Nephrolithotomy (PCNL) surgery remains a challenge. The Enhanced Recovery after Surgery guidelines advocates using regional anaesthesia procedures to minimise narcotic analgesics whether possible. Erector spinae plane (ESP) block has gained popularity in patients undergoing PCNL surgery due to its effective perioperative analgesia, improved patient satisfaction. Our aim of this study was to find out the efficacy of erector spinae plane block in percutaneous nephrolithotomy surgery.Methods This randomised controlled trial was conducted in 40 patients of American Society of Anesthesiologist (ASA) physical status I and II, aged between 18 to 70 year posted for percutaneous nephrolithotomy surgery. Divided in to two group. Group C: general anaesthesia with intravenous analgesia, while Group E: general anaesthesia with erector spinae plane block (ESP).Results The perioperative 24 hour consumption of fentanyl (mcg) was more in Group C (189.86 ± 141.11) than Group E (44.90 ± 80.83) and there was a significant difference between the two groups (0 .001). Time of first rescue analgesia was lower in group C (1.10 ± 0.75) than group E (8.18 ± 3.93) the difference between the groups was significant (p<0.001). NRS score was significantly higher in group C at various time intervals (from 0 hours to 24 hours) (p<0.001). Patient satisfaction was higher in group E (9.10±0.55) than group C (6.80±1.11) the difference between the group was significant (0.001).Conclusions We concluded that ESP block significantly reduces the perioperative opioid consumption, in patients undergoing PCNL surgery.