Serratus anterior versus erector spinae plane block for post-thoracotomy pain in pediatrics

Background Thoracotomy is a severe burden on children and is well-known to induce intense, acute pain. Aim To evaluate the effectiveness of serratus anterior plane block (SAPB) and thoracic erector spinae plane block (ESPB) in reducing pain in pediatric patients following thoracotomy. Patients and methods This prospective randomized study involved 105 participants aged two to seven years planned for thoracotomy. All individuals were classified into three equal groups: group I: administered general anesthesia (GA) alone as a control group, group II: administered GA with ultrasound guided SAPB, and group III: administered GA with ultrasound-guided ESPB. Results Groups II and III had substantially lower Face, leg, activity, cry, and consolability score (FLACC) at 3 h compared with group I, although there was not a substantial distinction between groups II and III. Face, leg, activity, cry, and consolability score was found to be considerably lower in groups II and III at 6–8 h compared with group I and III than group II. Time of first rescue analgesia was significantly higher in (group II and III) compared with group I and III compared with group II. Conclusion Both SAPB and ESPB provide superior analgesic effects in comparison with control in children who underwent thoracotomy. However, as compared with SAPB, ESPB offers better analgesia with delayed time of first-rescue analgesia, more hemodynamic stability, lower morphine consumption, and pain scores.