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Utilizing Preoperative Rectus Sheath Blocks to Decrease Opioid Administration During Pediatric Umbilical Hernia

Derek J Krinock¹, Benjamin Moore¹, Stephen M Bowman²

¹Department of Surgery, University of Arkansas for Medical Sciences, Little Rock, AR, USA.

Journal of Pediatric Surgery

|January 29, 2025

Summary

This summary is machine-generated.

Preoperative bilateral rectus sheath block (BRSB) significantly decreased opioid use in pediatric patients undergoing umbilical hernia repair (UHR). The regional anesthetic block also provided adequate pain control for most patients, reducing the need for postoperative analgesics.

Keywords:

Analgesia Anesthesia Opioid Pain Umbilical hernia

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Area of Science:

Pediatric Anesthesiology
Regional Anesthesia
Pain Management

Background:

Regional anesthetic blocks are crucial for reducing pediatric opioid use and enhancing perioperative pain management.
Umbilical hernia repair (UHR) is a common pediatric surgical procedure where effective pain control is essential.

Purpose of the Study:

To compare opioid utilization in pediatric patients undergoing UHR with and without a preoperative bilateral rectus sheath block (BRSB).
To evaluate the efficacy of BRSB in providing adequate postoperative pain control in this patient population.

Main Methods:

A single-center retrospective cohort study compared two groups of pediatric patients (<18 years) undergoing UHR.
One group did not routinely receive BRSB (1/2019-7/2020), while the other did (1/2022-7/2023).
Data on demographics, medications, and BRSB outcomes were collected and analyzed using descriptive statistics and bivariate analysis.

Main Results:

Patients receiving BRSB showed significantly lower intraoperative (0.04 vs. 0.13 MME/kg, p < 0.001) and postoperative (0.02 vs. 0.04 MME/kg, p = 0.005) opioid administration.
Of patients who received BRSB, 97% reported adequate pain control, with the block's effect lasting a median of 9 hours.
No significant difference in patient demographics was noted between the groups.

Conclusions:

Preoperative BRSB in pediatric UHR reduces both intraoperative and postoperative opioid requirements.
BRSB is an effective regional anesthetic technique for achieving satisfactory pain control in pediatric patients undergoing UHR.
Regional anesthetic blocks offer a viable strategy for opioid-sparing pain management in pediatric surgery.