Background and Aims Venous malformations are the most frequent type¹ of vascular anomalies and scleroembolisation is the most common treatment method as it allows good results with low morbidity. Here, we present a successful ESP block in a pediatric patient for a scleroembolisation procedure.

Methods A 16 months old female patient was enrolled for scleroembolisation of a left subscapular venous malformation. After the induction phase (propofol 30 mg and fentanyl 30mcg) and IOT, ESPb was performed in right lateral position at the level of the transverse process of T3 with an ultrasound-guided injection of 10 ml Ropivacaine 0.15%.

Results Scleroembolisation procedure was performed after 20 minutes and lasted about 30 minutes, the patient presented a stable hemodynamic state, with excellent pain control.

The maintenance of anesthesia was guaranteed with Propofol 0,09 mg/kg/min. No opioids were needed during the surgery. At the end of the procedure, Paracetamol 100 mg iv was administered. Upon awakening, the patient was extubated without complications and was pain free. Post-operative pain relief was not administered as the patient reported no pain. The postoperative pain control was 0 on the FLACC scale at 12, 24 and 36 hours and the vital parameters have always been valid and stable. The patient didn’t have PONV.

Conclusions The ESP block for scleroembolisation procedures could be considered a valid block for intraoperative and postoperative pain control in pediatric age. The analgesia covers almost the entire perioperative phase, significantly reducing the use of other analgesics