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The following is a summary of “Utilizing Preoperative Rectus Sheath Blocks to Decrease Opioid Administration during Pediatric Umbilical Hernia Repair,” published in the January 2025 issue of Journal of Pediatric Surgery by Krinock et al.

Researchers conducted a retrospective study to compare opioid use in patients with pediatric undergoing umbilical hernia repair (UHR) with or without preoperative bilateral rectus sheath block (BRSB) to assess its impact on opioid utilization and perioperative pain control.

They conducted a retrospective cohort study on patients <18 years undergoing UHR, comparing 2 periods: 1/1/2019-7/31/2020 (no BRSB) and 1/1/2022-7/31/2023 (routine BRSB). Data on demographics, medications, BRSB procedure, and follow-up were collected, and bivariate analysis was performed.

The results showed that of 256 patients, the mean age was 5.1 years (SD = 2.4), and 55% were female. Intraoperative opioids were lower with BRSB (0.04 vs. 0.13, P < 0.001), as were post-anesthesia opioids (0.02 vs. 0.04, P = 0.005). Of 132 patients who received BRSB, 121 (92%) had follow-up, with 97% (n = 117) reporting adequate pain control and a median BRSB duration of 9 hours (IQR 6-12).

Investigators found that BRSB reduced opioid use and provided satisfactory postoperative pain control in children undergoing UHR.

Source: jpedsurg.org/article/S0022-3468(25)00024-7/abstract