Background and Aims Renal surgeries in children, are associated with important post-operative pain. Good post-operative analgesia is essential to allow effective coughing and early mobilisation to reduce the occurrence of post-operative complications. This study was undertaken to compare the analgesic efficacy of morphine spinal anlgesia with ultrasound-guided single-shot paravertebral block in children undergoing renal surgeries

Methods sixty children aged 4 – 14 years, of ASA status I/II, posted for elective renal surgeries. Interventions: The children were randomised into two groups (Group MSA: morphine spinal analgesia, Group PVb: paravertebral block). After induction of general anesthesia, SA or paravertebral block was performed under ultrasound guidance, with respectivly morphine or 0.2% ropivacaine. Measurements: Time to first rescue analgesia, intraoperative and post-operative hemodynamics, post-operative FLACC scores, incidence of complications, parental satisfaction scores were recorded

Results Children in Group PVB had significantly longer duration of analgesia (p < 0.0004) than Group MSA. Post-operative FLACC scores (p < 0.005) and analgesic requirements (p < 0.0004) were lower in Group PVB. The mean fentanyl requirement over 24 h in group PVB was 0.56 ± 0.82 μg/kg, compared to 1.8 ± 1.2 μg/kg in groupMSA. Parents in Group PVB reported greater satisfaction (p < 0.02). No complications were seen in either of the groups.

Conclusions This study showed superior analgesia and parental satisfaction with single-shot paravertebral block in comparison to spinal anlgesia for renal surgeries in children. However, the block performance in children requires adequate expertise and practice