Comparison Between Ultrasound-Guided Erector Spinae Plane Block and Ultrasound-Guided Caudal Analgesia in Pediatric Cancer Patients Undergoing Surgical Resection of Renal and Suprarenal Tumors: A Randomized Clinical Trial

Abstract

Background: Pediatric patients undergoing cancer resection surgeries may experience undertreated perioperative pain. The caudal block has proven effective in various pediatric surgeries. The erector spinae plane block (ESPB), a recent regional block, has gained popularity across different age groups. Objectives: This study aims to investigate the analgesic efficacy and safety of ultrasound-guided ESPB versus ultrasound-guided caudal block in pediatric renal and suprarenal surgeries. Methods: This randomized trial included 80 ASA II and III pediatric cancer patients scheduled for open renal surgeries. They were randomly assigned to group C, where patients received an ultrasound-guided caudal block, or group E, where patients received an ultrasound-guided ESPB. Results: Heart rate (HR) values were higher at 30, 45, and 50 minutes intraoperatively and after 2 and 8 hours postoperatively for group C compared to group E (P < 0.05). Mean arterial pressure (MAP) values were lower intraoperatively at 45 minutes and postoperatively after 2 and 4 hours for group C compared to group E (P < 0.05). Postoperative pain scores (FLACC) and the time to receive the first dose of rescue analgesic were comparable between both groups (P > 0.05). Morphine consumption in the first 24 hours was significantly higher in group E compared to group C (1.61 ± 0.33 mg and 1.21 ± 0.66 mg, respectively; P-value = 0.002). Conclusions: The ESPB did not provide a better analgesic profile compared to the ultrasound-guided caudal block in pediatric patients undergoing surgeries for renal and suprarenal tumors.