Efficacy of ultrasound-guided bilateral erector spinae plane block in pediatric laparoscopic cholecystectomy: Case series

Postoperative opioid administration can cause various side effects, such as drowsiness, respiratory distress, postoperative nausea, and vomiting. The use of non-opioid medications as part of a multimodal analgesia method has been increasingly suggested in the management of acute postsurgical pain. Erector spinae plane block (ESPB), which is a regional anesthesia technique, blocks both visceral and somatic nerve fibers. Though it is infrequently used in young patients, presently described is a series of cases in which ESPB was successfully used in the performance of pediatric laparoscopic cholecystectomy. Ultrasound-guided bilateral ESPB was performed on 4 patients who underwent a laparoscopic cholecystectomy. An injection of 0.25% bupivacaine was administered into the interfascial area on each side in the pre-incisional period after the anesthesia induction (total anesthetic: 2.5 mg/kg). Postoperative pain control was planned at 10 mg/kg intravenous paracetamol every 8 hours. Numeric rating scale pain scores were less than 3 points in the post-anesthetic care unit, and at 1, 2, 4, 8, 12, and 24 hours. No rescue analgesic (1 mg/kg tramadol) was needed. None of the typical complications, such as drowsiness or nausea, were observed and no block-related complications were recorded. Bilateral ESPB that is a part of multimodal analgesia regimen can provide effective analgesia for pediatric laparoscopic cholecystectomy patients in the first 24 hours postoperatively

Pediatrik laparoskopik kolesistektomi için ulltrason rehberliğinde yapılan bilateral erector spina plan bloğun etkinliği: Vaka serileri

Ameliyat sonrası opioid uygulaması uyku hali ve solunum sıkıntısı, bulantı ve kusma gibi çeşitli yan etkilere neden olabilir. Multimodal analjezinin bir parçası olarak opioid olmayan ilaçlar, akut cerrahi sonrası ağrının tedavisinde giderek artan ölçüde öne sürülmektedir. Bölgesel bir anestezi tekniği olan Erector spinae plan bloğu (ESPB) hem visseral hem de somatik sinir liflerini bloke eder. Pediatrik cerrahi olgularda çok az uygulaması olan laparoskopik kolesistekomide postoperatif ağrı için bir ESPB vaka serisi sunduk. Laparoskopik kolesistektomi yapılan dört hastaya ultrason eşliğinde bilateral ESPB yapıldı. Anestezi indüksiyonundan sonra, insizyon öncesi dönemde her iki taraftaki fasyalar arasındaki alanına% 0.25 bupivakain enjekte edildi. (toplam anestezi: 2.5 mg/kg) Ameliyat sonrası ağrı kontolü, her sekiz saatte bir 10 mg / kg’lık parasetamol ile planlandı. NRS (sayısal puanlama ölçeği) ağrı skorları, anestezi sonrası bakım ünitesinde (PACU) 1, 2, 4, 8, 12 ve 24. saatlerde üç puanın altındaydı. Kurtarma analjeziklerine (1 mg/kg tramadol) ihtiyaç olmadı. Bu yüzden, uyuşukluk, bulantı ve kusma gibi komplikasyonlar olmadı. Blokla ilişkili herhangi bir komplikasyonla karşılaşılmadı. Multimodal analjezi rejiminin bir parçası olan ESPB’un iki taraflı uygulanması, pediatrik laparoskopik kolesistektomi için postoperatif ilk 24 saatte etkili analjezi sağlamaktadır.

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