Erector Spinae Plane Block vs Quadratus Lumborum Block for pediatric lower abdominal surgery: A double blinded, prospective, and randomized trial

Abstract Study objective To evaluate and compare the analgesic effect of ultrasound-guided erector spinae plane (ESP) block with ultrasound-guided Quadratus Lumborum Block in pediatric lower abdominal surgeries. Design Randomized, prospective, double-blinded trial. Setting Operating room and surgical ward. Patients Sixty patients, aged 1 to 7 years with ASA scores of I-II scheduled for elective lower abdominal surgery were included in the study. Interventions Patients were randomized into two groups as ESPB group and QLB group. Ultrasound guided ESP block at L1 vertebral level was performed preoperatively using 0.5 ml/kg 0.25% bupivacaine (max 20 ml) to the patients in ESPB group. And ultrasound guided QLB block with transmuscular approach was performed preoperatively using 0.5 ml/kg 0.25% bupivacaine (max 20 ml) to the patients in QLB group. Measurements Face, Legs, Activity, Cry and Consolability (FLACC) scores for pain were recorded at 0, 1, 3 and 6 h postoperatively. Analgesic requirements and time to first analgesic requirement were also recorded. Main results Fifty-seven patients were included in the final analyses. No significant difference was determined between the groups' FLACC scores at 0, 1, 3 or 6 h postoperatively (p > 0.05). No significant difference was also determined in times to first analgesia between the groups (p > 0.05). Conclusions This study shows that the ESPB provides similar postoperative analgesia to the QLB in pediatric patients undergoing lower abdominal surgery. Clinicians could decide according to their clinical experiences. Clinical Trials https://clinicaltrials.gov/ct2/show/NCT03463382 .