Journal Article

Erector Spinae Plane Block vs Quadratus Lumborum Block for pediatric lower abdominal surgery: A double blinded, prospective, and randomized trial

Baydemir, Canan, Akay, Mustafa Alper, Şen, Mehmet Celal, Gürkan, Yavuz, Aksu, Can

2019

Overview

To evaluate and compare the analgesic effect of ultrasound-guided erector spinae plane (ESP) block with ultrasound-guided Quadratus Lumborum Block in pediatric lower abdominal surgeries. Randomized, prospective, double-blinded trial. Operating room and surgical ward. Sixty patients, aged 1 to 7 years with ASA scores of I-II scheduled for elective lower abdominal surgery were included in the study. Patients were randomized into two groups as ESPB group and QLB group. Ultrasound guided ESP block at L1 vertebral level was performed preoperatively using 0.5 ml/kg 0.25% bupivacaine (max 20 ml) to the patients in ESPB group. And ultrasound guided QLB block with transmuscular approach was performed preoperatively using 0.5 ml/kg 0.25% bupivacaine (max 20 ml) to the patients in QLB group. Face, Legs, Activity, Cry and Consolability (FLACC) scores for pain were recorded at 0, 1, 3 and 6 h postoperatively. Analgesic requirements and time to first analgesic requirement were also recorded. Fifty-seven patients were included in the final analyses. No significant difference was determined between the groups' FLACC scores at 0, 1, 3 or 6 h postoperatively (p > 0.05). No significant difference was also determined in times to first analgesia between the groups (p > 0.05). This study shows that the ESPB provides similar postoperative analgesia to the QLB in pediatric patients undergoing lower abdominal surgery. Clinicians could decide according to their clinical experiences. https://clinicaltrials.gov/ct2/show/NCT03463382. •Erector Spinae Plane Block is a novel technique for postoperative analgesia in many indications.•Quadratus Lumborum Block is a well known analgesic technique for different pediatric surgeries.•Erector Spinae Plane Block provides similar analgesia to Quadratus Lumborum Block for pediatric lower abdominal surgeries.•Opioid sparing effect could be achieved with both Quadratus Lumborum and Erector Spinae Plane blocks in pediatric surgeries.

• Publisher: Elsevier Inc,Elsevier Limited
• Subject: Abdomen / Abdomen - surgery / Abdominal Muscles - innervation / Abdominal surgery / Age groups / Airway management / Analgesics / Anesthesia / Anesthetics, Local - administration & dosage / Bupivacaine - administration & dosage / Child / Child, Preschool / Double-Blind Method / Erector Spinae Plane Block / Ethics / Female / Hernias / Humans / Infant / Iodine / Male / Medical personnel / Nerve Block - methods / Pain / Pain Measurement / Pain Medicine / Pain, Postoperative - prevention & control / Paraspinal Muscles - innervation / Patients / Pediatric surgery / Pediatrics / Postoperative pain / Prospective Studies / Quadratus Lumborum Block / Ultrasonography, Interventional / Ultrasound