comparison between ultrasound-guided erector spinae plane block and ultrasound-guided caudal analgesia in pediatric cancer patients undergoing surgical resection of renal and suprarenal tumors: a randomized clinical trial

Background: pediatric patients undergoing cancer resection surgeries may experience undertreated perioperative pain. the caudal block has proven effective in various pediatric surgeries. the erector spinae plane block (espb), a recent regional block, has gained popularity across different age groups. objectives: this study aims to investigate the analgesic efficacy and safety of ultrasound-guided espb versus ultrasound-guided caudal block in pediatric renal and suprarenal surgeries.methods: this randomized trial included 80 asa ii and iii pediatric cancer patients scheduled for open renal surgeries. they were randomly assigned to group c, where patients received an ultrasound-guided caudal block, or group e, where patients received an ultrasound-guided espb. results: heart rate (hr) values were higher at 30, 45, and 50 minutes intraoperatively and after 2 and 8 hours postoperatively for group c compared to group e (p < 0.05). mean arterial pressure (map) values were lower intraoperatively at 45 minutes and postoperatively after 2 and 4 hours for group c compared to group e (p < 0.05). postoperative pain scores (flacc) and the time to receive the first dose of rescue analgesic were comparable between both groups (p > 0.05). morphine consumption in the first 24 hours was significantly higher in group e compared to group c (1.61 ± 0.33 mg and 1.21 ± 0.66 mg, respectively; p-value = 0.002). conclusions: the espb did not provide a better analgesic profile compared to the ultrasound-guided caudal block in pediatric patients undergoing surgeries for renal and suprarenal tumors.