Ultrasound‐guided erector spinae plane block for postoperative analgesia in pediatric patients undergoing splenectomy: A prospective randomized controlled trial

Mostafa, Shaimaa F.; Abdelghany, Mohamed; Abdelraheem, Taysser M; Elyazed, Mohamed M. Abu

doi:10.1111/pan.13758

Cited by 31 publications

(38 citation statements)

References 23 publications

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“…However, a recent cadaver study revealed that local anesthetics did not spread to the dorsal anterior branch in most cases [24]. Despite the uncertain mechanism of action, ESPB has been widely used as postoperative analgesic over the last few years, and it seems to have achieved satisfactory results [25][26][27]. A previous meta-analysis [28] demonstrated that ESPB is an effective strategy to improve postsurgical analgesia.…”

Section: Discussionmentioning

confidence: 99%

Postoperative Analgesic Efficacy of Erector Spinae Plane Block in Patients Undergoing Lumbar Spinal Surgery: A Systematic Review and Meta-Analysis

et al. 2021

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Lumbar spine surgery is one of the most widespread types of surgery for treating back and leg pain. However, the postoperative period always presents with severe pain due to the removal of skin, subcutaneous tissues, bones, and ligaments. Patients usually require high doses of opioids to relieve pain during the initial three days after operation, as well as experience drugrelated complications and prolonged length of stay in hospital. We found that Erector spinae plane block significantly reduced postoperative opioid consumption and pain scores. The present systematic review revealed that ESPB was effective and safe for postoperative analgesia.

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Section: Discussionmentioning

confidence: 99%

Postoperative Analgesic Efficacy of Erector Spinae Plane Block in Patients Undergoing Lumbar Spinal Surgery: A Systematic Review and Meta-Analysis

et al. 2021

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“…This ‘happily accidental’ block has been compared with other neuraxial techniques such as the epidural and paravertebral block and may prove to be a safer alternative 4. Although the ESP block has been successful in the adult population, there are only 42 documented cases (as of December 2019) in neonates, infant, and children 5–14. Despite the increasing number of indications for the ESP block, the anatomy, mechanism of action, concentration, and volume of anesthetic is yet to be determined especially in neonates and children 3 5…”

Section: Introductionmentioning

confidence: 99%

A cadaveric study of the erector spinae plane block in a neonatal sample

Govender

Möhr

Bösenberg

et al. 2020

Reg Anesth Pain Med

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BackgroundThe aim of this article was to provide a detailed description of the neonatal anatomy related to the erector spinae plane block and to report the spread of the dye within the fascial planes and potential dermatomal coverage.MethodsUsing ultrasound guidance, the bony landmarks and anatomy of the erector spinae fascial plane space were identified. The erector spinae plane block was then replicated unilaterally in two fresh unembalmed neonatal cadavers. Using methylene blue dye, the block was performed at vertebral levels T5—using 0.5 mL in cadaver 1—and T8—using 0.2 mL in cadaver 2. The craniocaudal spread of dye was tracked within the space on the ultrasound screen and further confirmed on dissection.ResultsCraniocaudal spread was noted from vertebral levels T3 to T6 when the dye was introduced at vertebral level T5 and from vertebral levels T7 to T11 when the dye was introduced at vertebral level T8. Furthermore, the methylene blue spread was found anteriorly in the paravertebral and epidural spaces, staining both the dorsal and ventral rami of the spinal nerves T2 to T12. Small amounts of dye were also found in the intercostal spaces.ConclusionIn two neonatal fresh cadavers, the dye was found to spread to multiple levels and key anatomic locations.

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“…ESP block has been used as an alternative to neuraxial blocks for a wide range of procedures 5,6,8,17,25‐32 . Further investigations are needed to be performed in a larger sample size to determine whether 0.3‐0.5 mL/kg provides adequate dermatomal spread in infants and children; whether “in‐plane” or “out‐of‐plane” improves spread; or whether needle insertion over the lateral tip of the transverse process affects the cranio‐caudal spread as opposed to needle placement deep to the erector spinae muscle between the transverse processes.…”

Section: Discussionmentioning

confidence: 99%

The extent of cranio‐caudal spread within the erector spinae fascial plane space using computed tomography scanning in a neonatal cadaver

Govender

Möhr

Schoor

et al. 2020

Pediatric Anesthesia

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Background The erector spinae plane block (ESP) is a novel approach for blockade of the spinal nerves in infants, children, and adults. Until recently, the gold standard for truncal procedures includes the paravertebral and epidural blocks. However, the exact mechanism by which this blockade is achieved is subject to debate. Methods 2.3 mL (1 mL/kg) of iodinated contrast dye was injected bilaterally into the erector spinae fascial plane of a fresh unembalmed preterm neonatal cadaver (weighing 2.3 kg), to replicate the erector spinae plane block and to track the cranio‐caudal spread of the contrast dye using computed tomography. The “block” was performed at vertebral level T8 on the right‐hand side and at vertebral level T10 on the left‐hand side. Results Contrast dye was spread over three dermatomal levels from T6 to T9 on the right‐hand side, while on the left‐hand side, the spread was seen over four dermatomal levels from T9 to T11/12. Contrast dye also spread over the costotransverse ligament, into the paravertebral space and further lateral from the lateral border of the erector spinae muscle into the intercostal space. However, no spread was seen in the epidural space. Conclusion The erector spinae plane block is a versatile technique that can be part of the multimodal postoperative analgesic strategy for truncal surgery. In this study, contrast material dye was tracked over four vertebral levels in the paravertebral space (suggesting an approximate volume of 0.5‐0.6 mL per dermatome).

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Ultrasound‐guided erector spinae plane block for postoperative analgesia in pediatric patients undergoing splenectomy: A prospective randomized controlled trial

Cited by 31 publications

References 23 publications

Postoperative Analgesic Efficacy of Erector Spinae Plane Block in Patients Undergoing Lumbar Spinal Surgery: A Systematic Review and Meta-Analysis

Postoperative Analgesic Efficacy of Erector Spinae Plane Block in Patients Undergoing Lumbar Spinal Surgery: A Systematic Review and Meta-Analysis

A cadaveric study of the erector spinae plane block in a neonatal sample

The extent of cranio‐caudal spread within the erector spinae fascial plane space using computed tomography scanning in a neonatal cadaver

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