A comparative study between ultrasound guided serratus anterior block and erector spinae block for perioperative analgesia in children undergoing upper thoracic surgeries: A randomized trial

Background and Aims: Post-operative pain has always been neglected in children. It is only recently that the issue is being given the much-needed consideration. Even today, the literature is sparse for paediatric post-thoracotomy pain management modalities. In this era of ultrasound guided (USG) regional blocks, serratus anterior plane block (SAPB) and erector spinae plane block (ESPB) seem to offer promising results. We aimed to compare the ESPB with SAPB in patients undergoing open thoracotomy. Material and Methods: Sixty paediatric patients of age 5–14 years, scheduled to undergo open thoracotomies, were divided into two groups: Group S (SAPB) and group E (ESPB). Each group received 0.5 ml/kg of 0.25% bupivacaine under USG blocks. The primary outcome of the study was to compare the postoperative pain scores using the Wong–Baker Faces scale. The secondary outcomes were to compare cumulative fentanyl consumption, time to initiation of chest physiotherapy, and duration of hospital stays. Results: The Faces score was significantly lower in Group E compared to Group S at 8 h, 12 h, 16 h, 20 h, and 24 h ( P < 0.05). The mean cumulative fentanyl requirement in Group S was higher than in Group E ( P = 0.002). Time to initiate chest physiotherapy and duration of hospital stays were both significantly shorter in Group E ( P < 0.05). Conclusions: ESPB is superior to SAPB in terms of providing better pain control and reduced opioid requirements in children post-thoracotomy.