A Comparative Study between Ultrasound Guided Erector Spinae Plane Block versus Paravertebral Block for Perioperative Pain Control in Pediatric Laparoscopic Surgeries

Background: In children, postoperative discomfort following laparoscopic procedures can be rather severe. Even with a multimodal analgesia regimen, it is frequently required to administer substantial dosages of opioids. Aim and objectives: to evaluate the efficacy of the US-guided ESPB and PVB for perioperative pain control in pediatric laparoscopic surgeries. Patients and methods: This study is a clinical trial that is prospective, randomized, double-blinded, and controlled. It is being undertaken on pediatric patients who are scheduled for laparoscopic operations. Randomization was obtained using the computer-generated random table. Allocation concealment was ensured, utilizing opaque sealed envelopes. The study occurred from October 2022 to November 2023 at the laparoscopy unit of Al-Azhar University Hospitals, including the Sayed Galal and Al-Hussein hospitals. Results: Compared to the PVB and ESPB groups, the control group experienced a considerably higher frequency of nausea (15 versus 5 and 3, P=0.001). Furthermore, there was no discernible difference between the PVB and ESPB groups in terms of bradycardia, vomiting, hypotension, or urine retention. Crucially, none of the patients in the three research groups reported severe side effects like pneumothorax. Regarding parent satisfaction grades, there was no discernible difference between the PVB and ESPB groups. Conclusion: The results support the idea that these regional anesthetic methods can significantly improve the postoperative experience for pediatric patients. The best course of action for pediatric laparoscopic patients will continue to be refined via more research and clinical experience.