الفهرس 
Title : Analgesic Effect of Ultrasound Guided Errector Spinae Plane Block Versus Ultrasound Guided Caudal Block in Pediatric Open Renal Surgeries : A Randomized Comparative Study
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Abstract
In the past years, pediatric applications of plexus and conduction nerve blocks have increased considerably. The errector spinae plane block (ESPB) in children has been reported as an effective technique for postoperative analgesia following open renal procedures.
This study was done to compare between ESPB and caudal block with ultrasound guidance as regards time of first request of rescue analgesia, acetaminophen, opioid consumption, degree of intra and postoperative pain relief, effect on hemodynamics and incidence of complications.
Fifty patients were recruited to undergo unilateral open renal surgeries and divided into two groups randomly. Their age ranged from 2 to 6 years old from both genders.
General anaesthesia was induced, blocks was given. Cardiometry leads were fixed properly with adhesive tape. Cardiac output (CO), stroke volume (SV) and stroke volume variations (SVV) readings were recorded. If SVV readings were above 13%, administration of fluid bolus of 8ml/kg was required. Bolus could be repeated till reach maximum 20ml/kg.
After the surgical procedure and during first 12 hours of the post operative period, quality of analgesia assessed immediately postoperative and then at 1, 2, 3, 4 , 6, 8 and 12 hours postoperatively using Children’s Hospital of Eastern Ontario Pain Scale (CHEOPS). Acetaminophen intravenousely was given as rescue analgesia (10 mg/kg) when needed in both study groups if CHEOPS pain score more than 6.If pain score remains more than 6 within 20 min, it was followed by the use of morphine intravenousely (0.05 mg/kg).It was given every 8 hours.
Our study, as regards time if first request of rescue analgesia, total acetaminophen and morphine consumption postoperatively showed significant differences between the two groups in favour of errector spinae plane block . No rescue analgesia was needed and no consumption was recorded during first 12 hours in the post operative period. Both blocks under ultrasound guidance proved to be safe with no recorded complications either intra or postoperatively.