Técnicas de anestesia regional Eco guiadas como una alternativa a la epidural en cirugía torácica pediátrica: una revisión narrativa de la literatura

Postoperative pain management in pediatric thoracic surgery remains a clinical challenge due to the limitations and risks of thoracic epidural analgesia, traditionally considered the gold standard. This narrative review evaluated alternative regional anesthesia techniques, analyzing 39 relevant articles from a comprehensive search. A growing trend was observed in the use of erector spinae plane block (ESPB) and paravertebral block (PVB) in procedures such as thoracotomies, sternotomies, scoliosis correction, and pectus excavatum repair. ESPB stood out as a safe, effective, and versatile technique, associated with reduced opioid use, fewer adverse effects, and better control of acute pain. Its integration into Enhanced Recovery After Surgery (ERAS) protocols and the usefulness of ultrasound guidance to improve performance were also highlighted. Despite methodological limitations, such as the lack of randomized pediatric trials, ESPB emerges as a promising alternative in pediatric regional anesthesia.