Anesthesia for Children with Neuromuscular Diseases

Sameera, Vattipalli; Rath, Girija Prasad; Athiraman, Umeshkumar

doi:10.1007/978-981-16-3376-8_35

Cited by 1 publication

(2 citation statements)

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“…41,42 As demonstrated by this study, ESPB allows for reducing propofol and remifentanil infusion during spine surgery, which is particularly important in preventing the development of PRIS, in children with neuromuscular disease. 43 Neurophysiological monitoring of spinal cord integrity by MEP (motor-evoked potential) and SSEP (somatosensory-evoked potential) are used for scoliosis surgery safety. 44,45 The anesthetic drugs, including remifentanil and propofol, inhibit the amplitudes of transcranial motor-evoked potentials in a dose-dependent manner.…”

Section: Discussionmentioning

confidence: 99%

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Effectiveness of the Bilateral and Bilevel Erector Spinae Plane Block (ESPB) in Pediatric Idiopathic Scoliosis Surgery: A Randomized, Double-Blinded, Controlled Trial

Domagalska,

Ciftsi,

Janusz

et al. 2024

Journal of Pediatric Orthopaedics

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Background: This study aimed to compare the effect of the ultrasound-guided bilateral and bilevel erector spinae plane block (ESPB) on pain scores, opioid requirement, intraoperative motor-evoked potentials (MEPs), and stress response to surgery expressed by the neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) versus standard analgesia methods following idiopathic scoliosis surgery. Methods: This was a prospective, double-blinded, randomized controlled trial. Sixty patients aged 10 to 18 years and physical status ASA 1 or 2 were randomized into 2 equal groups, each receiving an ESPB or sham block. The primary outcome was the pain scores (Numerical Rating Scale, NRS) within 48 hours after spinal correction and fusion surgery for idiopathic thoracic scoliosis. The secondary outcomes were total opioid consumption, NLR, and PLR levels at 12 and 24 hours postoperatively and intraoperative MEPs. Results: ESPB patients presented lower NRS scores, signifying less pain, at all time points (30, 60, 90, 120 min; and 6, 12, 24, and 48 h after surgery), all P<0.0001. The total opioid consumption, the incidence of nausea or vomiting, and the need for remifentanil and propofol during surgery were significantly lower in the ESPB group. The surgery-induced stress response expressed by NLR and PLR was considerably lower in the ESPB group. ESPB did not affect the intraoperative MEP’s amplitude. Conclusions: ESPB is effective for postoperative analgesia, can reduce opioid consumption in patients undergoing scoliosis surgery, and reduces the stress response to surgery. ESPB does not interfere with neuromonitoring. Level of Evidence: Level I.

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