Erector Spinae Plane Block in Children: a Narrative Review

Lucente, Monica; Ragonesi, G.; Sanguigni, Marco; Sbaraglia, Fabio; Vergari, Alessandro; Macchia, Rosa La; Antonicelli, Federica; Rossi, Marco

doi:10.4097/kja.22279

Cited by 14 publications

(14 citation statements)

References 81 publications

(128 reference statements)

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“…The pediatric publications are in line with the adult literature. Two recent reviews, one meta‐analysis, and one narrative review, conclude that the evidence base for ESPB in children is still suboptimal and largely inconclusive 42,43 . As in adults, it appears to be of some use in less invasive surgical procedures but not for more major surgery (e.g., video‐assisted thoracic surgery vs. posterolateral thoracotomy and pectus excavatum repair) 44,45 .…”

Section: Pediatric Fascial Plane Blocksmentioning

confidence: 99%

“…Two recent reviews, one meta-analysis, and one narrative review, conclude that the evidence base for ESPB in children is still suboptimal and largely inconclusive. 42,43 As in adults, it appears to be of some use in less invasive surgical procedures but not for more major surgery (e.g., video-assisted thoracic surgery vs. posterolateral thoracotomy and pectus excavatum repair). 44,45 It also provides additional analgesic effects when compared to no block or sham block 46,47 but is not beneficial when compared to other established regional anesthetic techniques.…”

Section: Erector Spinae Plane Block (Espb)mentioning

confidence: 99%

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Fascial plane blocks in children—Scientifically supported or not?

Lönnqvist

2023

Pediatric Anesthesia

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Since the introduction of Fascial Plane Blocks in 2007 there has been an enormous interest and application of Fascial Plane Blocks, evidenced by substantially more than 1000 PubMed items. Despite this gigantic number of publications, also including randomized controlled trials and meta‐analyses in children, there is still no clear‐cut insight into how much of the purported effect is in fact due to the blockade of nerve structures and how much is merely adding the well‐known analgesic and anti‐inflammatory effects of the plasma levels of local anesthetics that are achieved with these techniques. Furthermore, Fascial Plane Blocks appear useful only if compared to conventional multi‐modal analgesia (no block or placebo) and Fascial Plane Blocks lack the potency to provide surgical anesthesia on their own and appear only to be of value when used for minor‐moderate surgery. Despite the huge literature, there has so far not emerged any clinical situations where Fascial Plane Blocks have definitively been shown to be the block of choice, being decisively more effective than other established regional blocks. Lastly, Fascial Plane Blocks may appear as virtually free of complications, but case reports are emerging that point to a real risk for causing local anesthetic systemic toxicity when using Fascial Plane Blocks. This text aims to synthesize the current knowledge base regarding the Fascial Plane Blocks that are relevant to use in the pediatric context. In summary, there does currently not exist any convincing scientific evidence for the continued support for the use of Fascial Plane Blocks in children, except for the rectus sheath block and possibly also the transmuscular quadratus lumborum block.

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Section: Pediatric Fascial Plane Blocksmentioning

confidence: 99%

Section: Erector Spinae Plane Block (Espb)mentioning

confidence: 99%

Fascial plane blocks in children—Scientifically supported or not?

Lönnqvist

2023

Pediatric Anesthesia

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“…In 2017, Chin et al [ 47 ] reported a successful perioperative pain management using ESP block in a pediatric patient who underwent oncological thoracic surgery. Since then, the ESP block has been applied in a wide range of pediatric clinical scenarios [ 48 ].…”

Section: Fascial Plane Blocks For Cardiac Surgerymentioning

confidence: 99%

Current evidence of ultrasound guided fascial plane blocks for cardiac surgery: a narrative literature review

Hong¹,

Oh²,

Jo³

et al. 2022

Korean J Anesthesiol

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“…The thoracic paravertebral block is an alternative technique to epidural catheter in these patients. Furthermore, new methods of regional analgesia, such as intercostal nerve block and erector spinae plane block, are also applied as part of multimodal analgesia regimens [13][14][15].…”

Section: Introductionmentioning

confidence: 99%

Maximum Pain at Rest in Pediatric Patients Undergoing Elective Thoracic Surgery and the Predictors of Moderate-to-Severe Pain—Secondary Data Analysis

Tomaszek,

Fenikowski,

Cież-Piekarczyk

et al. 2024

JCM

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Introduction: Pain management among children following thoracic surgery is an area of significant practice variability. Understanding the risk factors of moderate-to-severe pain intensity will allow for adequate pain relief. The aim of the study was to assess the maximum intensity of pain at rest in pediatric patients within 24 h of thoracic surgery and to investigate the prevalence and predictors of moderate-to-severe pain. Methods and findings: This is a prospective cohort study of patients in observational and randomized controlled trials following thoracic surgery. A secondary analysis of data was conducted using data collected from 446 patients aged 7–18 years undergoing thoracic surgery. The primary endpoint was maximum pain intensity (Numerical Rating Scale; NRS; range: 0–10) and the secondary endpoint was the prevalence and predictors of moderate-to-severe pain (NRS > 2/10). The median maximum pain in the cohort was 3 [0; 4]. During the immediate postoperative period, 54% of patients reported a maximum NRS > 2/10. The infusion of morphine by an intravenous route (vs. epidural route) was a protective factor against moderate-to-severe pain. Taking into account the findings related to the type of epidural analgesia (vs. intravenous morphine), it was found that only the administration of 0.25% bupivacaine combined with morphine or fentanyl was a protective factor against moderate-to-severe postoperative pain. Patients aged 14–18 years (vs. aged 7–13 years) had an increased risk of reporting pain as moderate-to-severe. Conclusions: The route of analgesic administration, type of multimodal analgesia, and patients’ age predict moderate-to-severe pain in pediatric patients after thoracic surgery.

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Erector Spinae Plane Block in Children: a Narrative Review

Abstract: This article has been accepted for publication and has undergone full peer review but has not been through the copyediting, typesetting, pagination, and proofreading processes, which may lead to differences between this version and the version of record.

Cited by 14 publications

References 81 publications

Fascial plane blocks in children—Scientifically supported or not?

Fascial plane blocks in children—Scientifically supported or not?

Current evidence of ultrasound guided fascial plane blocks for cardiac surgery: a narrative literature review

Maximum Pain at Rest in Pediatric Patients Undergoing Elective Thoracic Surgery and the Predictors of Moderate-to-Severe Pain—Secondary Data Analysis

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