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ESRA19-0400 Erector spinae plane block for open nephrectomy: a new paediatric success
  1. G Nogueira1,
  2. V Artilheiro2 and
  3. G Costa3
  1. 1Hospital Vila Franca Xira, Anaesthesiology, Lisboa, Portugal
  2. 2Centro Hospitalar de Lisboa Ocidental, Anaesthesiology, Lisboa, Portugal
  3. 3Centro Hospitalar de Lisboa Central, Anaesthesiology, Lisboa, Portugal


Background and aims Open nephrectomy is associated with severe pain and pain-derived morbidity. There are several options for postoperative pain management, each with drawbacks. Since its description in 2016,1erector spinae plane block (ESPB) has been deemed as a safe and effective regional technique. We present one of the few reports of a paediatric open nephrectomy, managed with the novel ESPB.

Methods A 1-year-old male, 9,6 kg, ASA I, diagnosed with a left Wilms tumour, was proposed for a total open nephrectomy. Informed consent was obtained. After induction of general anaesthesia and intubation, the patient was positioned in lateral decubitus. A high-frequency linear ultrasound probe was placed longitudinally on the left side, parasagittal to the level of T7-9. Following identification of the erector spinae muscle and transverse process of T8 vertebra, 0,5 ml/kg of ropivacaine 0,2% was injected unilaterally, deep to the erector spinae muscle, with an in-plane needle technique. The cranio-caudal spread of local anaesthetic was tracked to T6-10 level. The intraoperative period was uneventful and multimodal postoperative analgesia was maintained with acetaminophen and metamizole.

Results The follow-up on the surgical ward denoted a maximum FLACC score of 2 during the first 24h and of 1 thereafter, until discharge. No rescue analgesia was needed. Thereby, we recognize ESPB as a valuable option for open nephrectomy paediatric cases.

Conclusions The current report adds to the scarce body of literature regarding ESPB in infants. Moreover, our results support ESPB as a valid pain management alternative for open nephrectomy in this population.


  1. Reg Anesth Pain Med 2016. DOI:10.1097/AAP.0000000000000451.

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