Akademik Veri Yönetim Sistemi
NIGERIAN JOURNAL OF CLINICAL PRACTICE, cilt.2023, sa.26, ss.779-786, 2023 (SCI-Expanded)
Background: Erector spinae plane (ESP) block is a regional anesthesia technique
that blocks both somatic and visceral nerve fbers. Despite its high analgesic
potential, its mechanism of action is not yet fully understood. The ultrasound-guided
ESP block, which can be easily performed, makes important contributions to the
control of intraoperative pain in pediatric patients undergoing abdominal surgery.
The follow-up of pain in the intraoperative period is usually done by evaluating the
changes in hemodynamic parameters. Due to physiological differences in pediatric
patients, it is more difcult to do this with only hemodynamic changes than in adult
patients. Aim: The NOL® (Nociception Level) monitor calculates the nociception/
pain score by evaluating many parameters through a proprietary algorithm. Our
primary aim was to demonstrate the effectiveness of ESP block with an advanced
pain monitor in this patient group; our secondary aim was to investigate the necessity
of pain monitors in the pediatric patient group. Methods: In this case series, we
applied intraoperative NOL® monitoring in addition to standard monitoring (ECG,
SpO2, heart rate, EtCO2) in pediatric patients (16 cases) who were scheduled
for abdominal surgery and underwent ESP block. Results: Considering the
hemodynamic data, NOL values, postoperative pain scores, side effects, and
complications, it was concluded that ESP block can be used safely in this patient
group. Although the hemodynamic data and the NOL® index were compatible with
each other after a nociceptive stimulus, the NOL index was less affected by other
variables and gave the clinician clearer information about pain.