Background: Inflow occlusion of the portal triad is a common blood loss-reducing method during hepatectomy which may induce ischemic-reperfusion injury of the remaining parts of the liver. Dexmedetomidine is used for reducing ischemic-reperfusion injury in hepatectomy. Aim: The aim of this study was to assess the protective effect of dexmedetomidine on liver after partial hepatectomy using inflow occlusion. Setting and Design: This prospective controlled, double-blinded, randomized study included any patients of either sex with age between 20 and 70 years, those in physical status American Society of Anesthesiologists Classes I and II, and those who were planned for partial hepatectomy. Patients and Methods: Patients with elective hepatectomy were randomized into dexmedetomidine group, which received dexmedetomidine at 0.3 mg/kg/h, and control group, which received a placebo. Statistical Analysis: Statistical analysis was performed using IBM SPSS software version 18. Data were tested using Kolmogorov–Smirnov test, independent t -test or Mann–Whitney U-test, and Chi-square or Fisher's exact test. The statistical significance was considered at P < 0.05. Results: Serum albumin, aspartate aminotransferase, alanine aminotransferase, prothrombin time were higher in control group in comparison to dexmedetomidine group. Hypotension duration was lower in control group in comparison to dexmedetomidine group. Vasoconstrictor usage, amount of blood loss, and colloid, crystalloid, and blood given to patients were higher in control group in comparison to the study group. Conclusions: Dexmedetomidine can protect the liver during hepatic resection surgery with inflow occlusion with decreasing blood loss and need for blood transfusion.

Background: Postoperative pain management in children can be effectively controlled using regional analgesic techniques. In general, neuraxial blocks pose a higher risk of adverse effects and complications in comparison to peripheral nerve blocks. Recently, both quadratus lumborum block (QLB) and erector spinae plan block (ESPB) have been used to achieve adequate postoperative analgesia in children. We compared the efficacy of both in postoperative pain management after laparoscopic abdominal surgery. Methodology: Eight five patients with laparoscopic abdominal surgery received either bilateral QLB or ESPB at the level of T8 transverse process with 0.5 ml/kg of 0.25% bupivacaine to achieve adequate postoperative analgesia. FLACC score was used to assess pain score after surgery and the need for rescue opioid analgesia. Results: The average dose of fentanyl was lower and the time to the first dose of rescue analgesic was longer in QLB group when compared to ESPB group. In addition, FLACC scores were significantly lower in QLB group in comparison to ESPB group at the 6th, 8th, 12th and 20th h after surgery. Conclusion: Quadratus lumborum block can provide longer and more effective postoperative analgesia in pediatric patients following laparoscopic abdominal surgery in comparison to erector spinae plan block. Citation: Taman HI, Saber HIES, Farid AM, Elawady MM. Bilateral erector spinae plane block vs quadratus lumborum block for pediatric postoperative pain management after laparoscopic abdominal surgery: a double blinded randomized study. Anaesth. pain intensive care 2022;26(5):602-607; DOI: 10.35975/apic.v26i5.2017

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