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

J Clin Anesth. 2019 Nov:57:24-28. doi: 10.1016/j.jclinane.2019.03.006. Epub 2019 Mar 6.

Abstract

Study objective: To evaluate and compare the analgesic effect of ultrasound-guided erector spinae plane (ESP) block with ultrasound-guided Quadratus Lumborum Block in pediatric lower abdominal surgeries.

Design: Randomized, prospective, double-blinded trial.

Setting: Operating room and surgical ward.

Patients: Sixty patients, aged 1 to 7 years with ASA scores of I-II scheduled for elective lower abdominal surgery were included in the study.

Interventions: Patients were randomized into two groups as ESPB group and QLB group. Ultrasound guided ESP block at L1 vertebral level was performed preoperatively using 0.5 ml/kg 0.25% bupivacaine (max 20 ml) to the patients in ESPB group. And ultrasound guided QLB block with transmuscular approach was performed preoperatively using 0.5 ml/kg 0.25% bupivacaine (max 20 ml) to the patients in QLB group.

Measurements: Face, Legs, Activity, Cry and Consolability (FLACC) scores for pain were recorded at 0, 1, 3 and 6 h postoperatively. Analgesic requirements and time to first analgesic requirement were also recorded.

Main results: Fifty-seven patients were included in the final analyses. No significant difference was determined between the groups' FLACC scores at 0, 1, 3 or 6 h postoperatively (p > 0.05). No significant difference was also determined in times to first analgesia between the groups (p > 0.05).

Conclusions: This study shows that the ESPB provides similar postoperative analgesia to the QLB in pediatric patients undergoing lower abdominal surgery. Clinicians could decide according to their clinical experiences. CLINICAL TRIALS: https://clinicaltrials.gov/ct2/show/NCT03463382.

Keywords: Erector Spinae Plane Block; Pediatric surgery; Postoperative pain; Quadratus Lumborum Block; Ultrasound.

Publication types

  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Abdomen / surgery*
  • Abdominal Muscles / innervation
  • Anesthetics, Local / administration & dosage*
  • Bupivacaine / administration & dosage*
  • Child
  • Child, Preschool
  • Double-Blind Method
  • Female
  • Humans
  • Infant
  • Male
  • Nerve Block / methods*
  • Pain Measurement
  • Paraspinal Muscles / innervation
  • Postoperative Pain / prevention & control
  • Prospective Studies
  • Ultrasonography, Interventional

Substances

  • Anesthetics, Local
  • Bupivacaine

Associated data

  • ClinicalTrials.gov/NCT03463382