Analgesic efficacy of ultrasound guided erector spinae plane block versus serratus anterior plane block in pediatric patients undergoing aortic coarctectomy; a randomized controlled study

BACKGROUND: Aortic coarctectomy (AC) is associated with marked intraoperative hemodynamic alterations and significant post-thoracotomy pain. In this study, the analgesic effects of erector spinae plane block (ESPB) and serratus anterior plane block (SAPB) were compared. METHODS: 28 pediatric patients were randomized into the ESPB group (received unilateral ESPB using a volume of 0.4 ml/kg of bupivacaine 0.25% and lidocaine 1% on the same side of the planned thoracotomy) and the SAPB group (received unilateral block by injecting the same local anesthetic volume and mixture at the level of the 5th rib). Both blocks were given after anesthetic induction. The primary endpoint was total intraoperative fentanyl dose, while postoperative pain scores and the first 24 h morphine dose were secondary endpoints. RESULTS: Intraoperative fentanyl consumption (mcg/kg) didn't show a significant difference between the ESPB group (1.21 ± 0.43) and the SAPB group (1.36 ± 0.5), mean difference = 0.14, 95% CI (-0.21 to 0.50), p value = 0.421. Pain scores and first 24 h. morphine dose after surgery were comparable between both groups, p > 0.05. CONCLUSION: Both SAPB and ESPB provided comparable perioperative analgesia in pediatric AC, which was reflected by comparable intraoperative fentanyl dose, postoperative pain scores, and postoperative morphine dosage. TRIAL REGISTRATION: NCT06567275, trial registration date: (22-08-2024).