This study aims to evaluate the influence of ultrasound-guided erector spinae plane block on postoperative pain and diaphragmatic dysfunction in pediatric patients undergoing thoracoscopic sympathectomy.

Pain may occur after pediatric thoracic surgery in cases such as skin incision creation, rib traction, and drain placement, and in other cases, such as rib nerve injury. Such pain is highly unfavorable to pediatric patients' recovery as it may lead to reduced cough strength for clearing secretions, decreased functional residual capacity, and pulmonary complications such as atelectasis and pneumonia.

Erector spinae plane block (ESPB) is a novel trunk block to relieve chronic neuropathic pain. Since then, it has gained prominence as a regional anesthesia technique with the potential to revolutionize postoperative pain management, and it has been effectively administered not only for the management of perioperative pain for a wide variety of surgeries but also for the management of acute post-traumatic pain and chronic pain.

Inclusion Criteria:

• Age from 6 to 16 years.
• Either sexes (male or female).
• American Society of Anesthesiologists (ASA) physical status I-II.
• Scheduled for bilateral thoracoscopic sympathectomy under general anesthesia.

Exclusion Criteria:

• History of allergy to local anesthetics.
• Abnormal liver/kidney function.
• Severe spinal deformities.
• Bleeding or coagulation disorders.
• Skin damage or infection at the proposed puncture site.

The data will be available upon a reasonable request from the corresponding author after the end of study for one year.

After the end of study for one year.

The data will be available upon a reasonable request from the corresponding author.