Pediatrics Clinical Trial
Official title:
Comparison of Erector Spinae Plane Block With Transversus Abdominus Plane Block for Peri-operative Pain Management in Pediatric Open Pyeloplasty Cases
Regional anesthesia decreases the need for intravenous analgesia in the peri-operative period. Erector spinae plane (ESP) and transversus abdominus plane (TAP) blocks are two common regional anesthesia techniques shown to be effective in open abdominal surgeries. We aim to compare effectiveness of ESP block with TAP block for peri-operative analgesia in pediatric open pyeloplasty patients with a flank incision.
Regional anesthesia for effective post-operative pain management is a part of the pediatric
Enhanced Recovery After Surgery (ERAS) protocol. Epidural anesthesia is the gold standard for
analgesia for open abdominal surgeries, however difficulties in application and possible
complications deter clinicians from utilizing this method. Safe and effective alternatives to
epidural anesthesia has been a critical and popular focus of clinical research in recent
years. Transversus abdominus plane (TAP) block is an alternative technique shown to be
effective in pediatric open abdominal surgeries.
Erector spinae plane (ESP) block was described as an effective block for multi-dermatome pain
after thoracic surgery. It is emerging as a safe and easy-to-perform alternative to epidural
anesthesia for pelvic, abdominal and thoracic surgery.
During an open pyeloplasty, the flank incision goes through the transversus abdominus plane,
where the local anesthetic is injected for TAP block. This may weaken the analgesic effect of
the block. In the ESP block, local anesthetic diffuses cranio-caudally through the fascia of
erector spinae muscles and the flank incision does not disturb this plane. We aim to compare
the effectiveness of ESP block with TAP block in open pyeloplasty patients.
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