Background and aims Use of paravertebral bloc (PVB) as an anesthetic technique to overcome the use of morphine intraoperatively is lacking. the objective of study was to evaluate the effectiveness of this block as anesthetic technique and kidney surgery of the child.
Methods Prospective observational study conducted over 6 months in anesthesia department, Rabat Children’s Hospital. the PVB technique under ultrasound was used at T9. No morphine was delivered during the anesthetic induction. Hemodynamic parameters were recorded every 5 minutes during the duration. the quality of immediate postoperative analgesia (assessed by FLACC scale) and the need for rescue analgesia were collected in SSPI. Failure of the block was defined intraoperatively by the use of opioids with tachycardia and/or PAS > 20% of the baseline value recorded at induction, and/or immediately postoperatively by FLACC > 2.
Results 34 patients were included in the study. the median age was 96 months and the median weight was 25 kilograms. 24 patients underwent nephrectomy including 16 for nephroblastoma and 8 for mute kidney. 10 patients underwent surgery for a pyeloureteral junction syndrome. a successful BPV was observed in 86%. In 14% of the cases, one intraoperative administration of opioid as well as immediate postoperative analgesia was necessary. the median time between extubation and waking was 4 minutes. This delay was the most prolonged in the event that the failure of the block was noted. No patient presented complications.
Conclusions This study is among the first studies to evaluate the effectiveness of PVB as an anesthetic technique in children. a randomized study of a larger workforce would be needed to support these results.
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