Effect of erector spinae plane block on postoperative analgesia after pediatric hip surgery: Randomized controlled study

Abstract

Background Erector spinae plane block (ESPB) in pediatric patients presenting for hip surgery may improve the postoperative analgesia. Aim The study aimed to investigate the effect of ultrasound‐guided ESPB on postoperative analgesia after a pediatric hip surgery. Methods Forty children scheduled for hip surgeries were included in this trial and randomly distributed into; Control group, patients received sham ultrasound‐guided ESPB at the level of L3 or ESPB group, patients received real ultrasound‐guided ESPB at the level of L3 with an injection of 0.4 ml/kg of plain bupivacaine 0.25%. The time for the first call of rescue analgesia, intraoperative fentanyl consumption, postoperative morphine consumption, Children's Hospital Eastern Ontario Pain Scale (CHEOPS), and Objective Behavioral Pain score (OPS) were recorded. Results As compared to the control group, the use of ESPB significantly prolonged the time for first request of rescue analgesia from 170.50 ± 44.066 to 256.50 ± 66.434 min (p < 0.0001), decreased the intraoperative fentanyl consumption from 1.025 ± 0.379 to 0.775 ± 0.343 μg/kg (p = 0.035), decreased the postoperative morphine consumption from 0.105 ± 0.036 to 0.065 ± 0.023 mg/kg (p = 0.0002). Also, it significantly decreased postoperative CHEOPS and OPS scores 2, 4, and 6 h after the surgery (p < 0.05) with an insignificant difference between the two groups at all other time intervals (p ˃ 0.05). Conclusion The use of ESPB in pediatric patients undergoing hip surgery prolonged the time for the first call of analgesia, decreased the intraoperative and postoperative opioid consumption, and decreased the postoperative pain.

Comparison of ultrasound-guided erector spinae plane block with ultrasound-guided pericapsular nerve group block for paediatric hip surgery: A randomised, double-blinded study

“…[ 16 ] concluded that ESP block was an effective analgesic block for open paediatric midline splenectomy with lower postoperative pain scores and intraoperative fentanyl intake. Following Abduallah et al .’s results,[ 17 ] this study recorded that ESP blocks for paediatric hip surgeries could result in a longer first request for postoperative analgesia, minimising intraoperative fentanyl and postoperative morphine consumption and pain measurements. This research did not observe a change in the frequency of adverse effects and the level of parental satisfaction.…”