Analgesic effect of ultrasound-guided erector spinae plane block versus ultrasound-guided caudal block in pediatric open renal surgeries: A randomized comparative study

Background: We aimed to compare erector spinae plane block (ESPB) and caudal block (CB) with ultrasound guidance as regards time of first request of rescue analgesia, opioid consumption, degree of postoperative pain relief, and incidence of complications in pediatric patients undergoing open renal surgeries such as nephrectomy and pyeloplasty. Materials and Methods: Fifty children were recruited to undergo unilateral open renal surgeries and divided into two-equal groups randomly. The age of both genders ranged from 2 to 6 years . After general anesthesia had been induced, blocks were given. After the surgical procedure and during the first 12 h of the postoperative period, the quality of analgesia was assessed immediately postoperative and then at 1, 2, 3, 4, 6, 8, and 12 h postoperatively using Children's Hospital of Eastern Ontario Pain Scale (CHEOPS). Opioid was intravenously given as rescue analgesia (0.05 mg/kg) when needed in both groups if CHEOPS pain score exceeded 6. It could be given every 8 h if needed. Results: As regards the time of the first request of rescue analgesia and total morphine consumption postoperatively, there was a marked difference between the two groups in favor of erector spinae plane block as no rescue analgesia was needed during the first 12 h in the postoperative period. It was proved that both blocks under ultrasound guidance were safe with no recorded complications were noted either intra or postoperatively. Conclusion: ESPB provided effective prolonged analgesia postoperatively with lower pain scores as compared with the CB in children undergoing open renal surgeries.