Erector Spinae Plane Block for Paediatric Upper Abdominal Surgery

Patients will receive erector spinae plane block (ESP) at the level of T 9-10. Following skin sterilization, high-frequency linear ultrasound probe will be placed 1-2 cm lateral to the midline at the T 9 level. After identification of the erector spinae muscle (ESM) and the transverse process; a 22 G needle will be inserted, in a cranio-caudal direction, deep into the ESM in an in-plane technique. Correct needle placement will be verified with the administration of 0.5-1 ml Normal Saline to view the hydrodissection between the transverse process and the ESM. 0.25% Bupivacaine in a calculated volume of 0.5 ml/kg (with a maximum dose of 20 ml) will be injected deep to the erector spinae muscle for unilateral ESPB.

Post-operative rescue analgesic plan will consist of 15 mg/kg Paracetamol IV if the FLACC \[Face, Leg, Activity, Cry, Consolability\] score is 2-4 and 1 mg/kg Tramadol IV if FLACC score \> 4.