Comparison of thoracic epidural and ultrasound guided erector spinae plane block in pediatric thoracic surgeries

Abstract

OBJECTIVE: The objective of this study was to compare the efficacy of thoracic epidural and ultrasound-guided (USG) erector spinae plane block in pediatric thoracic surgeries. MATERIALS AND METHODS: Eight patients undergoing elective thoracic surgeries – videoscopic-assisted thoracic surgeries were divided into two groups, Group A – who received single-shot thoracic epidural using 0.125% bupivacaine in a dose of 0.5 ml/kg and Group B – who received USG erector spinae block (ESP block) using 0.125% bupivacaine in a dose of 0.5 ml/kg. Postprocedure visual analog scale (VAS) score was used to assess pain for the first 24 h. Pain assessment was done 6th hourly. Time of the first requirement of analgesics was noted and injection paracetamol 15 mg/kg intravenously was given as rescue analgesic. RESULTS: In Group A, VAS scores were higher compared to Group B. The duration of analgesia with single-shot epidural lasted for about 4–6 h postoperative whereas that with ESP block lasted for 8 or 10 h postoperatively. The time of the first requirement of analgesics was earlier in Group A compared to Group B. CONCLUSION: USG ESP block provides better analgesia compared to thoracic epidural.

Keywords

• erector spinae block
• pediatric thoracic surgeries
• rescue analgesia
• ultrasound