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Comparison of single-dose erector spinae plane block versus paravertebral block for pyeloplasty surgery in children -

Raksha Kundal1, Nitin Hayaran2, Vishal Kant3

  • 1Department of Anaesthesia, All India Institute of Medical Sciences Vijaypur, Jammu, India.

Journal of Anaesthesiology, Clinical Pharmacology
|January 6, 2025
PubMed

Insights

Erector spinae plane block (ESPB) and paravertebral block (PVB) offer effective pain relief for pediatric pyeloplasty. ESPB demonstrates a higher success rate and lower complication risk, making it a potentially advantageous option for post-operative analgesia.

Area of Science:

  • Anesthesiology
  • Pediatric Surgery
  • Pain Management

Background:

  • Open pyeloplasty in children often results in significant post-operative pain.
  • Paravertebral block (PVB) is a common method for managing this pain.
  • Erector spinae plane block (ESPB) is a newer technique showing promise for pediatric abdominal surgery analgesia.

Purpose of the Study:

  • To compare the effectiveness of ESPB versus PVB for post-operative pain control in children undergoing pyeloplasty.
  • To evaluate pain scores, analgesic requirements, and complication rates between the two block techniques.

Main Methods:

  • A randomized, assessor-blinded study involving 80 pediatric patients undergoing pyeloplasty.
  • Patients received either ultrasound-guided ESPB or PVB.
  • Post-operative pain was assessed using FLACC and VAS scales, with rescue analgesia and complications recorded.

Main Results:

  • No significant differences in pain scores (FLACC/VAS) or time to first rescue analgesia were observed between ESPB and PVB.
  • The incidence of hematoma at the block site was significantly lower with ESPB (0%) compared to PVB (10%).
  • The first puncture success rate was significantly higher for ESPB.

Conclusions:

  • Both ESPB and PVB are effective for managing post-pyeloplasty pain in children.
  • ESPB offers advantages due to its ease of performance and lower incidence of block-site hematoma.
  • ESPB may be a more advantageous regional anesthesia technique for pediatric pyeloplasty.
Abstract

Keywords:
ChildParavertebral block (PVB) controls pain in lower thoracic and upper abdominal surgeries. Our results show that erector spine plane block provides equivalent analgesia and a lower incidence of hematoma than PVB in pediatric pyeloplasties.hematomanerve blockpainpostoperative

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