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Abstract

Background & objective: Upper abdominal surgery has been known to adversely affect the respiratory activity of pediatric patients due to the significant postoperative pain. We aimed to assess the efficacy of erector spinae plane block in addition to general anesthesia (GA) in such surgeries and its role in improving the analgesia and outcomes in children.
Methodology: A randomized controlled study was conducted on 40 pediatric patients scheduled for elective open upper abdominal surgeries, such as open cholecystectomy, splenectomy, or operations on the kidneys as pyeloplasty, cyst excision & partial or total nephrectomy at Abo-Elreesh Hospital, Cairo, from November 2020 to November 2022. The patients were equally divided into Group C, which received GA, with no block, and Group E, which received erector spinae plane block (ESPB) after GA. Hemodynamics were recorded intraoperative and up to 1 hour postoperatively. Analgesic quality and respiratory dynamics were assessed postoperatively.
Results: Total postoperative tramadol consumption was significantly reduced in Group E (21.3 ± 11.7) compared to Group C (71.7 ± 19.7), P < 0.001. HR values during the procedure and up to 1 hour after surgery were significantly decreased by the ESPB (P < 0.001). Respiratory activity parameters (rate, depth, and oxygen saturation) were significantly improved in Group E (P < 0.001).
Conclusion: ESPB decreased intraoperative nociception and improved the postoperative analgesia, which resulted in better respiratory activity with fewer requirements for oxygen supplements.
Research clinical trial registration number: NCT04518215
Abbreviations: ESPB: erector spinae plane block, ESM: erector spinae muscle, GA: general anesthesia, HR: heart rate, MAP: mean arterial pressure, PACU: post-anesthesia care unit, FLACC: Face, Leg, Activity, Cry, Consolability
Keywords: erector; spinae; pediatric; block; abdominal; surgery
Citation: Seif NE, Salem AKS, Gado AAM, Jaccoub VF. Ultrasound-guided erector spinae plane block for pediatric upper abdominal surgery: a randomized controlled study. Anaesth. pain intensive care 2025;29(7):663-669. DOI: 10.35975/apic.v29i7.2942
Received: April 17, 2025; Revised: September 02, 2024; Accepted: September 10, 2025