Effect of erector spinae plane block on postoperative analgesia after pediatric hip surgery: Randomized controlled study.

Abstract

Erector spinae plane block (ESPB) in pediatric patients presenting for hip surgery may improve the postoperative analgesia. The study aimed to investigate the effect of ultrasound-guided ESPB on postoperative analgesia after a pediatric hip surgery. Forty children scheduled for hip surgeries were included in this trial and randomly distributed into; Control group, patients received sham ultrasound-guided ESPB at the level of L3 or ESPB group, patients received real ultrasound-guided ESPB at the level of L3 with an injection of 0.4ml/kg of plain bupivacaine 0.25%. The time for the first call of rescue analgesia, intraoperative fentanyl consumption, postoperative morphine consumption, Children's Hospital Eastern Ontario Pain Scale (CHEOPS), and Objective Behavioral Pain score (OPS) were recorded. As compared to the control group, the use of ESPB significantly prolonged the time for first request of rescue analgesia from 170.50±44.066 to 256.50±66.434min (p<0.0001), decreased the intraoperative fentanyl consumption from 1.025±0.379 to 0.775±0.343μg/kg (p=0.035), decreased the postoperative morphine consumption from 0.105±0.036 to 0.065±0.023mg/kg (p=0.0002). Also, it significantly decreased postoperative CHEOPS and OPS scores 2, 4, and 6h after the surgery (p<0.05) with an insignificant difference between the two groups at all other time intervals (p˃0.05). The use of ESPB in pediatric patients undergoing hip surgery prolonged the time for the first call of analgesia, decreased the intraoperative and postoperative opioid consumption, and decreased the postoperative pain.