Ultrasound-Guided Lumbar Erector Spinae Plane Block versus Intravenous Analgesics for Post-Operative Pain Management in Pediatric Patients Undergoing Inguinal Hernia Surgeries

Abstract Background Ultrasound guided nerve block is considered a recent technique for pain management. It provides better visualization of the nerves and reduces the risk for complications e.g. unintended injury to adjacent structures. Erector spinae plane Block (ESPB) is a promising technique in the field of pediatric postoperative analgesia considering its safety and simplicity. Aim of the Work to assess the analgesic efficacy of ultrasound guided Lumbar ESPB in pediatric patients undergoing unilateral inguinal hernia repair for postoperative analgesia. Patients and Methods The study was conducted in Ain Shams university Hospitals after approval of the ethics committee and written patients’ consent. It included a total of 40 pediatric patients aged 1-7 years, Scheduled for unilateral inguinal hernia repair. Patients were randomly divided into two equal groups, 20 each, according to the inclusion and exclusion criteria. Group A (n = 20): Received ultrasound guided ESPB block.Group B (n = 20): (the controlled group): This group didn't not receive any peripheral nerve block. The patient received the intravenous analgesia according to standard protocol. [(0.5 μg/Kg fentanyl) 5 min before skin incision.] Results The main finding in this study was that ultrasound guided ESPB at level of Lumbar transverse process provided a good analgesic effect in pediatric patients undergoing unilateral inguinal hernia repair by Prolonging the time to first request of analgesia (duration of analgesia). It also reduced the total amount of Intraoperative and postoperative i.v analgesic consumption in comparison to controlled group without associated any adverse effects or complications like nausea and vomiting, nerve injury, respiratory depression and hematoma formation. Conclusion Ultrasound-guided Lumbar ESPB provided significantly prolonged postoperative analgesia and reduced the postoperative analgesic requirements in pediatric patients underwent unilateral inguinal hernia repair.