Key result
Ultrasound-guided erector spinae plane block significantly reduced FLACC pain scores at 1 hour postoperatively (estimated difference -0.9) compared to general anesthesia alone in pediatric patients undergoing lower abdominal surgery.
Why the study?
Does ultrasound-guided erector spinae plane block improve perioperative analgesia in pediatric patients undergoing lower abdominal surgery?
RCT (n=51)
Double-blind
Computer-generated sequence
No
Does ultrasound-guided erector spinae plane block improve perioperative analgesia in pediatric patients undergoing lower abdominal surgery?
Mean Difference: -0.9 (95% CI -1.6–-0.3)
p-value: p=0.003
Ultrasound-guided erector spinae plane block provides effective perioperative analgesia and reduces intraoperative opioid requirements in children undergoing lower abdominal surgery.
May support ESPB for added rSO2 benefits in pediatric abdominal surgery; extends limited pediatric RCT data on regional blocks.
Background Erector spinae plane block (ESPB) can provide effective analgesia in pediatric abdominal surgery. Additionally, when used as an analgesic method in abdominal surgery, ESPB may increase regional intra-abdominal tissue oxygen saturation (rSO2) throughout the operation. However, the number of related studies conducted on pediatric patients is insufficient. Results Fifty-two patients undergoing lower abdominal surgery were allocated into two groups, the ESPB (E) and the control (C). Group E received general anesthesia plus unilateral ultrasound-guided ESPB, and group C received general anesthesia alone. Intraoperative fentanyl consumption, Face, Legs, Activity, Cry, Consolability (FLACC) score, time to first rescue analgesia and adverse events were recorded over the first 24 h postoperatively. The rSO2 level was evaluated in both groups throughout the operation. The FLACC score was significantly lower in group E than in group C (p<0.05). Four patients in group E required intraoperative fentanyl compared to 12 patients in group C (p<0.05). The first rescue analgesic administration time was significantly longer in group E than in group C (p<0.05). No significant difference in rSO2 values was detected between the groups (p>0.05). However, in group E, rSO2 values were significantly increased after the block compared to the postinduction values. Conclusions ESPB provides effective perioperative analgesia in children undergoing low abdominal surgery. Although there was no significant difference in rSO2 values between the groups, ESPB administration consistently increases rSO2 over time. Trial registration The trial was registered at ClinicalTrials.gov before patient enrolment ( NCT03808129 -13.12.2018).
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Pınar et al. (2022) conducted an RCT in Pediatric lower abdominal surgery (n=51). Ultrasound-guided erector spinae plane block vs. General anesthesia alone was evaluated on FLACC scale values at 1 h postoperatively (estimated difference -0.9, 95% CI -1.6, -0.3, p=0.003). Ultrasound-guided erector spinae plane block significantly reduced FLACC pain scores at 1 hour postoperatively (estimated difference -0.9) compared to general anesthesia alone in pediatric patients undergoing lower abdominal surgery.
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