• J. Cardiothorac. Vasc. Anesth. · Sep 2023

    Randomized Controlled Trial

    Bilateral Ultrasound-Guided Mid-Point Transverse Process to Pleura Block for Perioperative Analgesia in Pediatric Cardiac Surgery: A Randomized Controlled Study.

    • Ibrahim Abdelbaser, Ahmed Refaat Abourezk, Aboelnour Badran, and Mahmoud Abdelfattah.
    • Department of Anesthesia and Surgical Intensive Care, Faculty of Medicine, Mansoura University, Mansoura, Egypt. Electronic address: ibraheem2005@mans.edu.eg.
    • J. Cardiothorac. Vasc. Anesth. 2023 Sep 1; 37 (9): 172617331726-1733.

    ObjectiveMid-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.DesignA single-center, randomized, double-blinded, controlled, superiority study.SettingAt a University Children's Hospital.ParticipantsFifty-two patients aged 2 to 10 years who underwent open-heart surgery.InterventionsPatients were randomized to receive either bilateral MTP block or no block (control).Measurements And Main ResultsThe 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).ConclusionsSingle-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.Copyright © 2023 Elsevier Inc. All rights reserved.

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