Comparison of thoracic epidural and ultrasound guided erector spinae plane block in pediatric thoracic surgeries

N. Reddy, Sandhya Ghodke, R. Hiremath, Smita M. Nimbannavar, MaheshKrishna Kulkarni
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Abstract

OBJECTIVE: The objective of this study was to compare the efficacy of thoracic epidural and ultrasound-guided (USG) erector spinae plane block in pediatric thoracic surgeries. MATERIALS AND METHODS: Eight patients undergoing elective thoracic surgeries – videoscopic-assisted thoracic surgeries were divided into two groups, Group A – who received single-shot thoracic epidural using 0.125% bupivacaine in a dose of 0.5 ml/kg and Group B – who received USG erector spinae block (ESP block) using 0.125% bupivacaine in a dose of 0.5 ml/kg. Postprocedure visual analog scale (VAS) score was used to assess pain for the first 24 h. Pain assessment was done 6th hourly. Time of the first requirement of analgesics was noted and injection paracetamol 15 mg/kg intravenously was given as rescue analgesic. RESULTS: In Group A, VAS scores were higher compared to Group B. The duration of analgesia with single-shot epidural lasted for about 4–6 h postoperative whereas that with ESP block lasted for 8 or 10 h postoperatively. The time of the first requirement of analgesics was earlier in Group A compared to Group B. CONCLUSION: USG ESP block provides better analgesia compared to thoracic epidural.
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小儿胸外科硬膜外与超声引导下竖脊机脊柱平面阻滞的比较
目的:本研究的目的是比较硬膜外胸廓和超声引导(USG)竖脊平面阻滞在小儿胸外科手术中的效果。材料与方法:8例择期胸腔镜辅助胸外科手术患者分为两组,A组接受单次硬膜外注射,剂量为0.125%布比卡因,剂量为0.5 ml/kg; B组接受0.125%布比卡因,剂量为0.5 ml/kg的USG竖脊阻滞(ESP阻滞)。术后视觉模拟评分法(VAS)评价前24小时疼痛,第6小时进行疼痛评价。记录首次使用镇痛药的时间,静脉注射扑热息痛15 mg/kg作为抢救镇痛药。结果:A组VAS评分高于b组,单次硬膜外镇痛持续时间约为术后4 ~ 6 h,而ESP阻滞持续时间为术后8 ~ 10 h。A组首次使用镇痛药的时间较b组早。结论:与胸段硬膜外阻滞相比,USG ESP阻滞具有更好的镇痛效果。
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