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Abstract
Surgical correction of congenital chest wall deformities induces profound somatosensory and visceral nociception, necessitating robust postoperative analgesic strategies to prevent respiratory complications in pediatric cohorts. This prospective, randomized, controlled trial investigates the analgesic efficacy and opioid-sparing potential of the ultrasound-guided erector spinae plane block compared to systemic opioid-based analgesia in children undergoing elective thoracoplasty. Integrating 78 patients aged 6 to 16 years, the study randomized participants into an intervention group receiving a bilateral erector spinae plane block with 0.2% ropivacaine and a control group managed with intravenous patient-controlled analgesia. Utilizing precise ultrasound navigation, the fascial plane targeting the T5 transverse process was injected to achieve dermatomal coverage. Statistical modeling revealed a dramatic attenuation in acute pain perception within the intervention cohort, registering a mean 24-hour resting pain score of 1.8 ± 0.6 compared to 4.5 ± 0.9 in the control arm (p < 0.001). Cumulative fentanyl equivalent consumption plummeted by 58.4% in the fascial block group, directly correlating with a profound reduction in postoperative nausea and respiratory depression. Implementing this advanced regional technique fundamentally optimizes pediatric recovery pathways, establishing the ultrasound-guided fascial approach as a superior, safer alternative to neuraxial techniques for major thoracic reconstructions.
References
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