Continuous Erector Spinae Plane Block in Paediatric VATS: A Case Series

Area of Science:

• Anesthesiology
• Pediatric Surgery
• Pain Management

Background:

• Video-assisted thoracoscopic surgery (VATS) for empyema and congenital diaphragmatic hernia (CDH) can cause significant postoperative pain.
• Thoracic epidural block is a common analgesic method but carries risks.
• Erector spinae plane (ESP) block is a newer regional anesthesia technique with limited data in pediatric VATS.

Purpose of the Study:

• To evaluate the efficacy and safety of continuous and single-shot erector spinae plane blocks in pediatric patients undergoing VATS.
• To assess the quality of postoperative analgesia and identify any adverse effects.

Main Methods:

• Retrospective case series of 7 pediatric patients (2-8 years) undergoing VATS for empyema or CDH.
• Ultrasound-guided erector spinae plane catheter insertion and local anesthetic administration.
• Continuous ESP block with bupivacaine and fentanyl for 48 hours post-extubation.

Main Results:

• All patients experienced excellent postoperative analgesia lasting over 48 hours.
• No significant side effects such as motor block, nausea, vomiting, or respiratory depression were observed.
• The technique was successfully implemented in both empyema decortication and CDH repair surgeries.

Conclusions:

• Continuous erector spinae plane block is an effective and safe analgesic modality for pediatric patients undergoing VATS.
• ESP block provides superior pain control with a favorable side effect profile compared to traditional methods.
• Further prospective randomized trials are recommended to confirm these findings.