Comparison of Multiple Injection Costotransverse Block and Erector Spinae Plane Block for Post-Sternotomy Pain Relief in Pediatric Patients Undergoing Cardiac Surgery: A Prospective Randomized Comparative Study.
J Cardiothorac Vasc Anesth
; 38(4): 974-981, 2024 Apr.
Article
en En
| MEDLINE
| ID: mdl-38326195
ABSTRACT
OBJECTIVE:
The aim of this study was to evaluate the efficacy of ultrasound-guided multiple injection costotransverse block (MICB) and compare it with erector spinae plane block (ESPB) for poststernotomy pain relief in pediatric cardiac surgical patients.DESIGN:
A prospective, randomized, double-blind, comparative study.SETTING:
At a single institution tertiary referral cardiac center.PARTICIPANTS:
A total of 90 children with acyanotic congenital heart disease requiring surgery via sternotomy.INTERVENTIONS:
Children were allocated randomly to 1 of the 3 following groups ESPB (group 1), MICB (group 2), or Control (group 3). Participants in groups 1 and 2 received 4 mg/kg of 0.2% ropivacaine for bilateral ultrasound-guided block after induction of anesthesia. Postoperatively, intravenous paracetamol was used for multimodal analgesia, and fentanyl/tramadol was used for rescue analgesia. MEASUREMENTS AND MAINRESULTS:
The modified objective pain score (MOPS) was evaluated at 0, 1, 2, 4, 6, 8, 10, and 12 hours postextubation. After all exclusions, 84 patients were analyzed. The MOPS score was found to be significantly lower in ESPB and MICB groups compared to the control group until 10 hours postextubation (p < 0.05), with no statistically significant difference at the 12th hour (p = 0.2198). The total intraoperative fentanyl consumption (p = 0.0005), need for fentanyl supplementation on incision (p < 0.0001), and need for rescue opioid requirement in the postoperative period (p = 0.034) were significantly lower in both the ESPB and MICB groups than the control group. There were no statistically significant differences in both primary and secondary outcomes between the ESPB and MICB groups.CONCLUSION:
Ultrasound-guided MICB was effective and comparable to ESPB for post-sternotomy pain management in pediatric cardiac surgical patients.Palabras clave
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Procedimientos Quirúrgicos Cardíacos
/
Bloqueo Nervioso
Tipo de estudio:
Clinical_trials
Límite:
Child
/
Humans
Idioma:
En
Revista:
J Cardiothorac Vasc Anesth
Asunto de la revista:
ANESTESIOLOGIA
/
CARDIOLOGIA
Año:
2024
Tipo del documento:
Article
País de afiliación:
India