Analgesia for tracheoesophageal fistula repair in neonates: a comparison of single shot thoracic paravertebral block and epidural block with ropivacaine

ABSTRACT

Perioperative pain treatment in neonates is often insufficient .we aimed to compare a single shot thoracic paravertebral and epidural block with ropivacine for analgesia of tracheoesophageal fistula repair in neonates. This study was carried out on 24 neonates, they were randomly allocated into two groups after general anesthesia, Group I had a single shot unilateral thoracic paravertebral block with 1ml/kg body weight of ropivacaine 0.375% and Group II had thoracic epidural block with 1ml/kg body weight of 0.375% ropivacaine. Mean heart rate and blood pressure, Mean concentration of Sevoflurane, neonatal infant pain Score [NIPS] were measured in both groups. There was no statistically significant difference in the mean sevoflurane concentration in both groups [2.1 +/- 0.34%] in group I versus 1.9 +/- 0.8%] in group II, There was statistically significant more decrease in the heart rate and mean blood pressure in the paravertebral group more than the epidural group. There was also equianalgesia effect regarding NIPS in both groups but longer duration of analgesia in the paravertebral group. Thoracic paravertebral block has equianalgesia effect with longer duration of analgesia and less decrease in the heart rate and mean blood pressure when compared to t horacic epidural block for analgesia of tracheoesophageal fistula repair in neonates