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Subject Area

Anesthesiology and Intensive Care

Article Type

Original Study

Abstract

Objectives To assess the efficacy and safety of ultrasound-guided erector spinae-plane block (ESPB) in neonates undergoing tracheoesophageal fistula repair regarding postoperative pain management with measurement of narcotic and anesthetic consumption, hemodynamic changes, and incidence of complications. Background Neonates' pain causes significant stress, which has adverse circulatory and ventilator effects. Thoracotomy produces damaging surgical insults due to damage to ribs and peripheral nerves. Patients and methods A prospective control study on 40 neonates scheduled for a trachea–esophageal fistula repair via thoracotomy was randomized to group E (20 patients). Ultrasound-guided ESPB group: 2.5 mg/kg bupivacaine 0.25% with epinephrine 1: 200 000 (maximum total volume 5 ml). Group-C (20 patients) control group will receive general anesthesia and systemic analgesia without any regional block. Results Group E had significantly lower Face, Legs, Activity, Cry, Consolability (FLACC) score than group C (P = 0.0186). The analgesic consumption 24-h postoperative was significantly lower in group E than group C (P = 0.0282). Group E had more hemodynamic stability as regards heart rate up to 12-h postoperative compared with group C (P = 0.0476). Conclusion ESPB provides effective pain relief in neonates undergoing tracheoesophageal fistula repair.

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