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

Aksu, Can; Şen, Mehmet; Akay, M.; Baydemır, Canan; Gürkan, Yavuz

doi:10.1016/j.jclinane.2019.03.006

Cited by 65 publications

(86 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…After reviewing the literature regarding ESPBs in children, we found 33 publications as of May 2019 (see Table ) . These included 28 different case reports (three or less patients), three case series (greater than three patients), and two randomized controlled trials.…”

Section: Resultsmentioning

confidence: 99%

“…It did not include the safety time‐out. While some authors have described using the prone position, as a group all our blocks are performed in the lateral decubitus (or occasionally a slightly more rotated semi‐prone position for bilateral blocks) with parasagittal ultrasound alignment . In order to maintain consistency in technique across all vertebral levels and to avoid re‐positioning the patient twice, we have not used the lateral (mid‐axillary line) transverse approach …”

Section: Discussionmentioning

confidence: 99%

“…Two randomized controlled trials were reviewed. Aksu et al studied the ESPB (28 patients) versus quadratus lumborum block for inguinal hernia, orchiopexy, and hydrocelectomy repair. Not surprisingly, the analgesic efficacy was similar since ESPB is targeting the same nerves as a quadratus lumborum block but in a more proximal location.…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Early experience with erector spinae plane blocks in children

Holland

Bösenberg

2020

Pediatric Anesthesia

View full text Add to dashboard Cite

Background An erector spinae plane block is a relatively new regional anesthetic technique. Apart from case reports and small series, the literature regarding pediatric use is limited. Aim Our objective was to determine the efficacy of the erector spinae plane block in children by measuring the heart rate response to incision. Secondary objectives included feasibility, safety, opioid consumption, and pain scores. Furthermore, we reviewed this block in children published since 2016. Study design Case Series; Level of evidence, IV. Methods With Institutional Review Board approval, a retrospective chart review was conducted on all patients who received erector spinae plane block for surgery between October 2017 and May 2019 at a single institution. Blocks were performed under anesthesia, using ultrasound guidance prior to surgical incision. Block details and hemodynamic and analgesic data were collected. In addition, a PubMed literature review was conducted to identify all erector spinae plane block related publications in patients ≤18 years of age. Results About 164 patients, 2 days‐19.4 years, weighing 2.3‐94.7 kg, received erector spinae plane blocks. For more than 79% of single injection blocks, placement time was ≤10 minutes. Using a heart rate increase of <10% at skin incision as criterion, 70.1% of patients had a successful block. Only 20% required long‐acting opioids intraoperatively. In a subset of infants who underwent gastrostomy surgery using a dose of 0.5 mL/kg, a local anesthetic spread of at least five dermatomes (0.1 mL/kg/dermatome) was achieved. Per the literature review, 33 publications described erector spinae plane block in 128 children. No complications were reported. Conclusion Erector spinae plane blocks are relatively easy to perform in children with no complications reported to date. The efficacy of the block for a broad spectrum of surgeries, involving incisions from T1 to L4, is encouraging.

show abstract

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Early experience with erector spinae plane blocks in children

Holland

Bösenberg

2020

Pediatric Anesthesia

View full text Add to dashboard Cite

show abstract

“…There are increasing reports of its use for different indications. As for many other regional techniques, reports of its use in pediatric patients are still limited and are also restricted to case reports, except for Aksu et al [7].…”

Section: Discussionmentioning

confidence: 99%

“…There have been a few randomized prospective studies of ESPB in terms of its clinical effectiveness, but all, with one exception, have involved adults [5][6][7]. Pediatric case reports are also limited compared to adults [8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24].…”

Section: Introductionmentioning

confidence: 99%

Defining the Indications and Levels of Erector Spinae Plane Block in Pediatric Patients: A Retrospective Study of Our Current Experience

Aksu¹,

Gürkan²

2019

Cureus

Self Cite

View full text Add to dashboard Cite

Aim The primary aim of this study was to evaluate the indications, effectiveness, application levels, and local anesthetic (LA) dosages used in erector spinae plane block (ESPB) in pediatric patients  based on our clinical data. The secondary aim was to compare previously reported pediatric ESPBs with our data and to prepare a mini-guide for future clinical applications.Materials and methodsOne hundred and forty-one pediatric patients who received ESPB and were operated by the Department of Pediatric Surgery were included in this retrospective observational study. ESPB is routinely performed with 0.5 ml/kg 0.25% bupivacaine (max 20 ml). Demographic data and the type of surgery were recorded. Face, Legs, Activity, Cry, and Consolability (FLACC) or Numeric Rating Scale (NRS) scores, analgesic requirements, and the type of analgesic administered at postoperative period were recorded.ResultsESPB was applied using three different techniques, the classic approach, the transverse approach, and the Aksu approach. Unilateral ESPB was performed on 112 patients, while 29 received a bilateral block. ESPB used for 13 different indications.ConclusionESPB is a relatively safe and effective procedure for achieving opioid-free postoperative analgesia in many different surgical procedures in pediatric patients.

show abstract

Unilateral sacral erector spinae plane block for lower limb surgery in children

Gupta

Kaur

Kumar

2022

Anaesthesia Reports

View full text Add to dashboard Cite

The erector spinae plane block is a versatile regional anaesthesia technique used for a variety of truncal surgeries. A novel variation is the sacral erector spinae plane block which is gaining popularity for perineal and anorectal procedures. Local anaesthetic injected at this level blocks the sacral dermatomes and has the potential for more proximal spread to involve lumbar nerve fibres via spread to the lumbar plexus or the epidural space. The advantage of a sacral erector spinae plane block over a neuraxial block is that it is less invasive and may have a better safety profile: there is a reduced risk of epidural haematoma, epidural abscess, haemodynamic instability and motor weakness of the lower extremities. Until now, this approach has been used for midline surgical procedures when the local anaesthetic was injected bilaterally. Its application for lower limb procedures with a single unilateral injection has not been described. We report the use of a unilateral sacral erector spinae plane block at the level of the S2 median crest in two children undergoing lower limb procedures of the hip and thigh. The block was found to provide effective peri-operative analgesia with minimal need for any opioid analgesics and without any significant adverse effects.

show abstract

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

Cited by 65 publications

References 24 publications

Early experience with erector spinae plane blocks in children

Early experience with erector spinae plane blocks in children

Defining the Indications and Levels of Erector Spinae Plane Block in Pediatric Patients: A Retrospective Study of Our Current Experience

Unilateral sacral erector spinae plane block for lower limb surgery in children

Contact Info

Product

Resources

About