Key result
Lumbar erector spinae plane block significantly reduced postoperative FLACC pain scores at 1 hour compared to saline control (median 1 vs 3, p<0.001) in children undergoing hip dysplasia surgery.
Why the study?
Open surgery for developmental dysplasia of the hip may cause severe pain, prompting evaluation of the analgesic effect of ultrasound-guided Lumbar Erector Spina Plane Block in pediatric patients.
Does ultrasound-guided lumbar erector spinae plane block improve postoperative analgesia and reduce opioid consumption in pediatric patients undergoing developmental hip dysplasia surgery?
RCT (n=60)
Double-blind
Computer-generated using Microsoft Excel RAND function
No
Does ultrasound-guided lumbar erector spinae plane block improve postoperative analgesia and reduce opioid consumption in pediatric patients undergoing developmental hip dysplasia surgery?
Ultrasound-guided lumbar erector spinae plane block significantly reduces postoperative pain scores and opioid consumption in pediatric patients undergoing developmental hip dysplasia surgery.
L-ESP block cuts opioid and ibuprofen use after pediatric DDH surgery; extends regional analgesia evidence to pelvic osteotomies.
Open surgery for developmental dysplasia of the hip (DDH) may cause severe pain due to tenotomies and pelvic-femoral osteotomies. This study aims to evaluate the analgesic effect of ultrasound-guided Lumbar Erector Spina Plane (L-ESP) Block in pediatric patients undergoing DDH surgery. Sixty children scheduled for DDH surgery were randomly assigned into two groups. Group I (n = 30) received L-ESP with 0.5 mL/kg of 0.25% bupivacaine before surgery. In contrast, Group II (n = 30), as the control group, received the same volume of saline injection. Identical postoperative analgesia protocol was adjusted for both groups. Parental satisfaction, pain levels, ibuprofen, and opioid consumption were recorded. Pain levels were evaluated with the FLACC (Face, Legs, Activity, Crying, Consolability) scale. FLACC scores at the first 24th hours were lower in the L-ESP group than the control group (p < 0.001). Rescue opioid utilization was higher in the control group (15/26) than in the L-ESP group (2/29) (p < 0.001). The consumption of ibuprofen was higher in the control group than in the L-ESP group in the ward (24/26 vs. 3/29, p < 0.001, respectively). Parental satisfaction was superior in the L-ESP group (p = 0.024). To provide postoperative analgesia for DDH surgery, ultrasound-guided L-ESP may be an effective and alternative regional anesthetic technique.
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Cirak et al. (2024) conducted an RCT in Developmental dysplasia of the hip (DDH) (n=60). Lumbar Erector Spinae Plane (L-ESP) Block vs. 0.5 mL/kg saline injection was evaluated on FLACC pain score at 1 hour postoperatively (p=<0.001). Lumbar erector spinae plane block significantly reduced postoperative FLACC pain scores at 1 hour compared to saline control (median 1 vs 3, p<0.001) in children undergoing hip dysplasia surgery.
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