Background and Aims Erector spinae plane block (ESPB) is a new paraspinal block that provides périopérative pain relief in thoracoabdominal surgery.ESPB seems to be a safe and effective alternative to thoracic paravertebral block. We report our experience in single shot ESPB for post operative pain management in newborns (NB) undergoing open type c esophageal atresia repair.

Methods Sixteen NB scheduled for open type C esophageal atresia repair were included in this prospective observational study (2017–2019). Blocks were performed in intubated asleep patients (propofol &,or sevoflurane). NB were placed in left Lateral decubitus. A right parasagital ESPB, was performed at the level of the forth dorsal vertebrae (D 04), followed by in plane injection of 0.5 ml/kg of 0.1% Bupivacaine. We considered as insufficient surgical analgesia any increase in heart rate beyond 20% of baseline and requiered rescue intravenous (IV) Alfentanyl (10 µg/kg).Postoperative pain was evaluated using the EDIN scale (every 4 hours) during The first post operative day. All newborns received intravenous paracetamol (7,5 mg/kg/6h). We have also noted incidents and complications.

Results 16 patients had a primary surgical repair (14 term NB, and 02 prematures). Mean age was 38 post menstrual weeks (36–41). Mean weight was 2150 g (1600–3200).Two NB (12,5%) required intra operative analgesia, but none in postoperative. No pneumothorax nor vascular puncture were noted.

Conclusions Integrated in a multimodal non opioid périopérative pain relief strategy, single shot ESPB seems to be a safe & effective alternative to tradittional thoracic epidural & paravertebral blocks, in newborns undergoing open type c esophageal atresia repair.