Related Experiment Video
Updated: Oct 6, 2025
Author Spotlight: Enhancing Success of Ultrasound-Guided Neuraxial Anesthesia in Cases with Difficult Anatomy
Published on: January 31, 2025
Effect of erector spinae plane block on postoperative analgesia after pediatric hip surgery: Randomized controlled
Mohammad A Abduallah1, Laila A Al-Ahwal1, Sameh A Ahmed1
1Department of Anesthesiology and Intensive Care, Faculty of Medicine, Tanta University, Tanta, Egypt.
Insights
Erector spinae plane block (ESPB) in pediatric hip surgery significantly reduces pain and opioid use. This technique prolongs the time to first pain relief, lowers intraoperative fentanyl, and decreases postoperative morphine.
Area of Science:
- Anesthesiology
- Pediatric Surgery
- Pain Management
Background:
- Erector spinae plane block (ESPB) is a regional anesthesia technique.
- Pediatric patients undergoing hip surgery often experience significant postoperative pain.
- Effective pain management is crucial for recovery in pediatric orthopedic procedures.
Purpose of the Study:
- To evaluate the efficacy of ultrasound-guided ESPB for postoperative analgesia in children.
- To compare pain scores and opioid consumption between ESPB and control groups.
- To determine the impact of ESPB on the need for rescue analgesia.
Main Methods:
- A randomized controlled trial involving 40 pediatric patients undergoing hip surgery.
- Patients were assigned to either a real ESPB group (0.25% bupivacaine) or a sham ESPB control group.
- Outcomes measured included time to first rescue analgesia, intraoperative fentanyl, postoperative morphine, CHEOPS, and OPS scores.
Main Results:
- ESPB significantly extended the time to first rescue analgesia (256.5 vs. 170.5 min).
- Intraoperative fentanyl consumption was reduced in the ESPB group (0.775 vs. 1.025 μg/kg).
- Postoperative morphine use and pain scores (CHEOPS, OPS) were significantly lower with ESPB.
Conclusions:
- Ultrasound-guided ESPB is effective in improving postoperative analgesia for pediatric hip surgery.
- ESPB reduces the requirement for opioid analgesics and associated pain.
- This technique offers a promising approach to multimodal pain management in pediatric orthopedic patients.
Background:
Erector spinae plane block (ESPB) in pediatric patients presenting for hip surgery may improve the postoperative analgesia.
Aim:
The study aimed to investigate the effect of ultrasound-guided ESPB on postoperative analgesia after a pediatric hip surgery.
Methods:
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 0.4 ml/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.
Results:
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 ± 66.434 min (p < 0.0001), decreased the intraoperative fentanyl consumption from 1.025 ± 0.379 to 0.775 ± 0.343 μg/kg (p = 0.035), decreased the postoperative morphine consumption from 0.105 ± 0.036 to 0.065 ± 0.023 mg/kg (p = 0.0002). Also, it significantly decreased postoperative CHEOPS and OPS scores 2, 4, and 6 h after the surgery (p < 0.05) with an insignificant difference between the two groups at all other time intervals (p ˃ 0.05).
Conclusion:
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.
More Related Videos
09:51The Transition to an Anterior-Based Muscle Sparing Approach Improves Early Postoperative Function but is Associated with a Learning Curve
Published on: September 7, 2022
09:07An Anesthesia, Surgery, and Harvest Method for the Evaluation of Transpedicular Screws Using an In Vivo Porcine Lumbar Spine Model
Published on: May 31, 2017
Related Concept Videos
01:11Local Anesthetics: Clinical Application as Spinal Anesthesia
01:29Local Anesthetics: Clinical Application as Epidural Anesthesia
Since epidural anesthetics can be infused through an epidural catheter, all types of drugs, including short-acting ones, can be administered. Chloroprocaine and lidocaine are examples of short and long-duration anesthetics, respectively. Bupivacaine...