Erector Spinae Plane Block for Pain Management in Pediatric Urologic Surgeries: A Narrative Review.

PURPOSE OF REVIEW: The erector spinae plane (ESP) block is a relatively novel regional anesthesia technique that has shown promising results in providing postoperative analgesia for pediatric urologic surgeries. Originally described for thoracic neuropathic pain, the ESP block has since expanded in use related to simplicity, safety, and efficacy across various surgical procedures. RECENT FINDINGS: This review explores the application of the ESP block in pediatric urology, including technique, dosing, indications, comparative advantages, and current evidence from case reports. Particular attention is given to its role in surgeries such as pyeloplasty, nephrectomy, and ureteral reimplantation, where both somatic and visceral pain must be effectively managed. Ultrasound guidance, the use of long-acting local anesthetics, and consideration of patient-specific factors make this technique especially suited for pediatric patients. While case-based evidence supports the block’s analgesic efficacy and opioid-sparing benefits, especially in comparison to traditional neuraxial techniques, limitations remain due to the lack of randomized trials and unclear patterns of anesthetic spread. Further research is needed to standardize practice and confirm the long-term utility of the ESP block in pediatric urologic surgery.