Comparison of conventional caudal block, ultrasound guided caudal block and ultrasound guided erector spinae block for pediatric hip surgery: A randomized double blinded study

Background: For these individuals, paediatric regional anaesthesia seems to be a preferable option for enhancing acute pain control with fewer side effects. The aim of this work was to compare the safety and efficacy of ultrasonography-guided caudal block (UC), conventional caudal block (CC), and erector spinae plane block (ESPB) for controlling pain following paediatric hip surgeries.Methods: This prospective randomized controlled double blinded study was carried out on 105 children who had been scheduled for elective unilateral hip surgeries. After general anesthesia induction, patients were categorized into three groups; Group I: received CC utilizing 0.5ml/kg plain bupivacaine 0.25%, Group II: received UC utilizing 0.5ml/kg plain bupivacaine 0.25%, Group III: received US guided ESPB using 0.5ml/kg plain bupivacaine 0.25% at L2 level.Results: Time to first rescue analgesic demand was substantially longer in group ESPB than groups CC and UC. Total consumption of tramadol was substantially reduced in group ESPB than groups CC and UC. Total paracetamol consumption, block performing time, side effects, success rate and parents’ satisfaction were insignificantly different among the three groups. FLACC (Face, Legs, Activity, Cry, Consolability) scale in ESPB group was significantly decreased than CC group at 4h and UC group at 4h but was substantially increased in group ESPB than group CC at 8h and UC group at 8h.Conclusions: In cases undergoing pediatric hip surgery, ESPB produced adequate analgesia that was comparable to CC and UC blocks with prolonged postoperative analgesia and less postoperative opioid consumption with more stable hemodynamic and low side effects.