Microtia Reconstruction and Erector Spinae Block in Children: A Case Series With Chart Review.

Document Type

Article

Publication Date

6-15-2021

Publication Title

Otolaryngology and head and neck surgery

Keywords

california; santa monica; psjhc

Abstract

OBJECTIVES: Autologous reconstruction of microtia is advantageous due to its inherent biocompatibility and long-term stability, but postoperative pain associated with costal harvest is a significant issue. A well-planned pain management approach is imperative. Our objective is to introduce the novel application of erector spinae block anesthesia in pediatric microtia reconstruction and evaluate its impact on pain scores, use of opioids, and hospital length of stay.

STUDY DESIGN: Case series with chart review.

SETTING: Patients undergoing stage 1 microtia reconstruction at a tertiary pediatric hospital.

METHODS: Data collected included demographics, opioid amounts, Wong-Baker FACES Pain Rating Scale scores, opioid-related side effects, and hospital length of stay. We used generalized estimating equations to examine the effect of erector spinae block use on total opioid use and pain scores and a linear regression model to assess the effect on hospital stay.

RESULTS: Forty-seven patients were included: 14 in the erector spinae block group and 33 in the continuous wound pump group. The mean age was 8.3 years (SD, 2; range, 6-13), and 13 (32%) were female. Patients in the erector spinae block group had a 65.44% decrease in adjusted total opioid use (95% CI, -79.72% to -41.10%;

CONCLUSIONS: This study demonstrates that early experience with an erector spinae block resulted in decreased opioid use and shorter hospital stay as compared with continuous wound infiltration with local anesthetic.

Clinical Institute

Neurosciences (Brain & Spine)

Clinical Institute

Women & Children

Department

Neurosciences

Department

Surgery

Department

Critical Care Medicine

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