Ultrasound Guided Single Injection Thoracic Paravertebral Block Versus Preemptive Surgical Incision Infiltration in Pediatric Renal Surgery

Aim and Objective: We compared ultrasound guided single injection thoracic paravertebral block, and preemptive local infiltration at the site of surgical incision as regard decreasing analgesic requirements, hemodynamic stability, and incidence of complications in children undergoing renal surgery.Material and Methods: 50 patients (2 to 10 years) scheduled to undergo open renal surgery were randomly assigned into one of two groups; one received ultrasound guided single injection thoracic paravertebral block after induction of general anesthesia (group PVB), the other group received local infiltration of skin, subcutaneous tissue, and muscles after induction of general anesthesia and preemptively before surgical incision, (group SII). Intraoperative, and postoperative hemodynamic and postoperative pain scores were assessed.Results: The current study demonstrated that ultrasound guided single injection thoracic paravertebral block was superior to the preemptive surgical incision infiltration in children undergoing open renal surgery, as it showed lower CHEOPS and OPS scores, less need of postoperative rescue analgesia and longer time to first request, however thoracic paravertebral block needed longer time to be performed. Both techniques showed hemodynamic stability during the intraoperative and postoperative periods.