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Bilateral Ultrasound-Guided Mid-Point Transverse Process to Pleura Block for Perioperative Analgesia in Pediatric Cardiac Surgery: A Randomized Controlled Study.
- Source :
-
Journal of cardiothoracic and vascular anesthesia [J Cardiothorac Vasc Anesth] 2023 Sep; Vol. 37 (9), pp. 1726-1733. Date of Electronic Publication: 2023 May 14. - Publication Year :
- 2023
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Abstract
- Objective: Mid-point transverse process to pleura (MTP) block is a new regional analgesia technique. This study aimed to assess the perioperative analgesic effects of MTP block in children undergoing open-heart surgery.<br />Design: A single-center, randomized, double-blinded, controlled, superiority study.<br />Setting: At a University Children's Hospital.<br />Participants: Fifty-two patients aged 2 to 10 years who underwent open-heart surgery.<br />Interventions: Patients were randomized to receive either bilateral MTP block or no block (control).<br />Measurements and Main Results: The primary outcome was fentanyl consumption in the first postoperative 24 hours. The secondary outcomes were intraoperative fentanyl consumption, modified objective pain score (MOPS) measured at 1, 4, 8, 16, and 24 hours after extubation, and the duration of stay in the intensive care unit (ICU). The mean (SD) postoperative fentanyl consumption (µg/kg) in the first 24 hours was significantly reduced in the MTP block group (4.4 ± 1.2) compared to the control group (6.0 ± 1.4, p < 0.001). The mean (SD) intraoperative fentanyl requirement (µg/ kg) was significantly reduced in the MTP block group (9.1 ± 1.9) compared to the control group (13.0 ± 2.1, p < 0.001). The MOPS was significantly reduced in the MTP block group compared to the control group at 1, 4, 8, and 16 hours after extubation but was comparable in both groups at 24 hours. The mean (SD) duration of ICU stay (hours) was significantly reduced in the MTP block group (25.0 ± 2.9) compared to the control group (30.7 ± 4.2, p < 0.001).<br />Conclusions: Single-shot bilateral ultrasound-guided MTP block in children undergoing cardiac surgery reduced the mean fentanyl consumption in the first postoperative 24 hours, intraoperative fentanyl requirements, pain score at rest, time to extubation, and duration of ICU stay.<br />Competing Interests: Declaration of Competing Interest None.<br /> (Copyright © 2023 Elsevier Inc. All rights reserved.)
Details
- Language :
- English
- ISSN :
- 1532-8422
- Volume :
- 37
- Issue :
- 9
- Database :
- MEDLINE
- Journal :
- Journal of cardiothoracic and vascular anesthesia
- Publication Type :
- Academic Journal
- Accession number :
- 37296029
- Full Text :
- https://doi.org/10.1053/j.jvca.2023.05.021