Analgesic efficacy of bilateral erector spinae plane block in pediatric tethered cord syndrome surgery: a prospective, randomized controlled trial.

OBJECTIVE: The aim of this study was to evaluate the analgesic efficacy of the ultrasound-guided erector spinae plane block in pediatric patients undergoing surgery for tethered cord syndrome. METHODS: In a randomized, prospective, single-blind study, 73 patients aged 1-18 years with American Society of Anesthesiologists I-III status scheduled for tethered cord syndrome surgery were divided into control and erector spinae plane block groups. In the erector spinae plane block group, 0.5 mL kg-1 of 0.25% bupivacaine was administered under ultrasound guidance. Pain assessment scores were recorded in the recovery unit during the first 20 min and on the ward during the first 24 h. The groups' need for rescue analgesia, intraoperative anesthetic drug consumption, and the time to the first postoperative analgesic request were investigated. RESULTS: The erector spinae plane block group had lower pain scores (up to approximately 4 h postoperatively), anesthetic and opioid consumption, and rescue analgesia requirements. A significant difference was observed in the time to first analgesic requirement. In total, 80.6% of patients in the control group still required additional analgesia at 30 min. CONCLUSION: The study demonstrated that erector spinae plane block delayed the time to first analgesic requirement and provided adequate postoperative analgesic effect in pediatric tethered cord syndrome surgery.