Comparison between Ultrasound-Guided Transversus Abdominis Plane Block and Ultrasound-Guided Erector Spinae Plane Block During Pediatric Laparoscopic Surgeries: A Randomized, Controlled, Prospective Study

Background: Pain after laparoscopic surgeries is caused by the incision and viscero-peritoneal pain due to peritoneal stretch and inflammation. Neonates and infants have increased sensitivity to narcotics. Ultrasound-guided erector spinae plane block (USG-ESPB) is a novel technique reported to have analgesic effect on somatic and visceral pain. We aimed to compare ultrasound guided TAPB (USG-TAPB) with USG-ESPB in providing peri-operative analgesia in pediatric participants undergoing laparoscopic surgeries. Methods: This single blinded, prospective, randomized controlled study was carried out on 84 participants aged from 2 months to 7 years old, scheduled for elective general laparoscopic surgeries. Participants were randomly allocated into two groups to receive either intraoperative ESPB and intravenous fentanyl (42 participant) or intraoperative TAPB and intravenous fentanyl (42 participant), and then further classified in to child and infant groups. Results: FLACC score was lower in the ESPB in (infant and child) with significance in the 4th, 8th and 12th hour assessment in infant and child group (P 0.05). The time to first postoperative analgesic requirement was significantly longer in the ESPB than in the TAPB (P < 0.001). Conclusions: When performing laparoscopic procedures on minors, ESPB proved to be an effective localized anesthetic method. ESPB had a more analgesic character than TAPB because its participants experienced extended block durations and less pain in the immediate postoperative phase.