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Background and Aims PSARP (Posterior Sagittal Anorectoplasty) surgery is a surgical procedure performed in children to correct anorectal malformations. After this surgical intervention, pain management is very important for children. Reports have emerged of rare cases of sacral erector spinae block (SESB). In the hypospadias operation, Aksu and Gürkan successfully performed SESB for postoperative analgesia.

Methods This is a retrospective case series of patients who underwent PSARP surgery at a tertiary university hospital between 2019 and 2023, and underwent SESB for postoperative analgesia. We administered propofol (2mg/kg), remifentanil (1 mcg/kg), and rocuronium (0.6 mg/kg) in anesthesia to the approved patients and operated on them in the pron position after entubation. After surgery, we administered 15 ml/kg of paracetamol intravenously to all patients. We recorded post-operative Flacc scores, analgesic consumption, and complications.

Results The scanning of anesthesia and pain follow-up forms revealed that 17 patients had undergone PSARP surgery. We observed ultrasound-guided SESB in 14 patients, 9 girls and 5 males, using 0.2% bupivacaine at 1 ml/kg. The average age of the patients was 20.64 ± 8.67 months, and their average weight was 12.14 ± 2.21 kilograms. Four patients received paracetamol intravenously at 10, 12, 14, and 16 hours after surgery. No patient should use opioids within 24 hours. Flacc scores remained low for 24 hours. (table 1) (figure 1) There were no complications.

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Abstract EP197 Figure 1

FLACC scores

Conclusions In anorectal surgeries, SESB may provide effective postoperative analgesia.