الفهرس | Only 14 pages are availabe for public view |
Abstract Thoracotomy pain management represents a major challenge, especially in neonates. Opioid-based analgesia has proved a difficult choice, mainly due to the associated respiratory depression when used in neonates. Regional anesthesia provides adequate perioperative analgesia, and the ultrasound guidance can dramatically increase the procedure’s success rate and minimize the incidence of technical complications. Paravertebral block (PVB) produces a unilateral somatic and sympathetic block which is advantageous in unilateral surgical procedures such as thoracotomy. Erector spinae plane block (ESPB) is a relatively new block used to provide chest wall analgesia and has thus far displayed an excellent safety profile. It is a facial plane block where a local anesthetic is injected between the erector spinae muscle and the underlying transverse process. ESPB affords an excellent margin of safety because of its more superficial depth and greater distance from important structures (e.g., spinal cord, pleura). The present study designed to compare the efficacy and safety of ultrasound-guided erector spinea plane block versus paravertebral nerve block in neonates undergoing tracheoesophageal fistula repair.A prospective randomized control study was conducted involving 3 groups; 1- group E; (20 patients) Ultrasound guided erector spinae plane block group; received 2–3 mg/kg bupivacaine 0.25% with epinephrine 1: 200 000 (maximum total volume 5 ml). 2- group P; (20 patients) Ultrasound guided Paravertebral block group; received 2–3 mg/kg bupivacaine 0.25% with epinephrine 1: 200 000 (maximum total volume 5ml). 3- group C; (20 patients) control group; received general anesthesia and systemic analgesia without any regional block. |