Please confirm that an ethics committee approval has been applied for or granted: Not relevant (see information at the bottom of this page)
Application for ESRA Abstract Prizes: I don’t wish to apply for the ESRA Prizes
Background and Aims Safe & effective perioperative analgesia is required for early recovery after open pyeloplasty surgeries. A single-shot caudal block is a widely accepted choice, however, it does not provide prolonged analgesia, and the addition of an adjuvant come with its inherent adverse effects. US- guided costo transverse block (CTB) has recently been introduced with cadaveric studies and clinical case reports, showing promising perioperative analgesia.
Methods After parental written informed consent, US-guided costo transverse block (CTB) was performed after general anesthesia (prone position) in 10 ASA I patients (mean age 3.95 yrs, weight 14.4 kg), scheduled for pyeloplasty surgery and 2mg/kg of 0.2% ropivacaine was deposited at three levels (thoracic T9-10,10,11,& 11,12). (figure1) Intraoperatively all patients received IV paracetamol and continued 6th hourly. Any pain response was not relieved by consolation and IV paracetamol was managed with fentanyl rescue(0.5mcg/kg)
Results The mean duration of surgery was 137 minutes. Intraoperatively 4 patients required fentanyl rescue. The mean time to rescue analgesic(fentanyl) not controlled by consolation and IV Paracetamol was 3 hrs, however, it was observed only in two patients. (table 1) None of the patients had any incision response. All the patients recovered well with a median FLACC on awakening 1/10 (0-2). All the patients had a good sleep with a median FLACC at 24 hours of 0/10( 0-1) and a maximum FLACC score of 4 in only one patient. (figure 2) We did not observe any procedure or local anesthetic- related complications
Conclusions US-guided CTB with multimodal analgesic provides safe and effective perioperative analgesia in pediatric open pyeloplasty surgeries.
Statistics from Altmetric.com
If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.