THE ANALGESIC EFFECT OF CONTINUOUS PARAVERTEBRAL BLOCK WITH DIRECT INTRAOPERATIVE CATHETER PLACEMENT FOR MINIMALLY INVASIVE OPEN-HEART SURGERY IN CHILDREN
Main Article Content
Abstract
Objective: To evaluate the intraoperative and postoperative pain relief results of continuous paravertebral block using a direct catheter placed during surgery for patients undergoing minimally invasive open heart surgery through the right mid-axillary approach in children. Subjects: 30 pediatric patients with congenital heart disease undergoing minimally invasive open heart surgery with continuous paravertebral block from March 2022 to September 2022. Methods: Descriptive, retrospective study. Results: After bolus the first dose of local anesthetic, 23/30 (76.7%) patients did not need additional fentanyl until the end of surgery. After surgery, 21/30 (70%) patients did not need additional morphin during the 3 days of the catheter paravertebral block placement. No patients were recorded with side effects of this nerve block method. Conclusion: Continuous paravertebral block via direct catheter placement during surgery for pediatric patients undergoing minimally invasive open heart surgery achieved good intraoperative and postoperative pain relief and high safety.
Article Details
Keywords
continuous paravertebral block, minimally invasive open heart surgery, children
References
2. Xiao, A.; Feng, Y.; Yu, S.; Xu, C.; Chen, J.; Wang, T.; Xiao, W. General Anesthesia in Children and Long-Term Neurodevelopmental Deficits: A Systematic Review. Front. Mol. Neurosci. 2022, 15, 972025. https://doi.org/ 10.3389/fnmol.2022.972025.
3. Suresh, S.; Ecoffey, C.; Bosenberg, A.; Lonnqvist, P.-A.; De Oliveira, G. S.; De Leon Casasola, O.; De Andrés, J.; Ivani, G. The European Society of Regional Anaesthesia and Pain Therapy/American Society of Regional Anesthesia and Pain Medicine Recommendations on Local Anesthetics and Adjuvants Dosage in Pediatric Regional Anesthesia: Regional Anesthesia and Pain Medicine 2018, 1. https://doi.org/10.1097/AAP.0000000000000702.
4. De Sonnaville, E. S. V.; Oosterlaan, J.; Ghiassi, S. A.; Van Leijden, O.; Van Ewijk, H.; Knoester, H.; Van Woensel, J. B. M.; Kӧnigs, M. Long-Term Neurocognitive Outcomes after Pediatric Intensive Care: Exploring the Role of Drug Exposure. Pediatr Res 2023, 94 (2), 603–610. https://doi.org/10.1038/s41390-022-02460-7.
5. Pollak, U.; Bronicki, R. A.; Achuff, B.-J.; Checchia, P. A. Postoperative Pain Management in Pediatric Patients Undergoing Cardiac Surgery: Where Are We Heading? J Intensive Care Med 2019, 088506661987143. https://doi.org/10. 1177/0885066619871432.
6. Yeung, J. H.; Gates, S.; Naidu, B. V.; Wilson, M. J.; Gao Smith, F. Paravertebral Block versus Thoracic Epidural for Patients Undergoing Thoracotomy. Cochrane Database of Systematic Reviews 2016, 2016 (3). https://doi.org/10.1002/ 14651858.CD009121.pub2.
7. Scarfe, A. J.; Schuhmann-Hingel, S.; Duncan, J. K.; Ma, N.; Atukorale, Y. N.; Cameron, A. L. Continuous Paravertebral Block for Post-Cardiothoracic Surgery Analgesia: A Systematic Review and Meta-Analysis. Eur J Cardiothorac Surg 2016, 50 (6), 1010–1018. https://doi.org/10.1093/ejcts/ezw168.
8. Álvarez-Baena, L.; Hervías, M.; Ramos, S.; Cebrián, J.; Pita, A.; Hidalgo, I. Continuous Thoracic Paravertebral Analgesia after Minimally Invasive Atrial Septal Defect Closure Surgery in Pediatric Population: Effectiveness and Safety Analysis. Revista Española de Anestesiología y Reanimación (English Edition) 2022, 69 (5), 259–265. https://doi.org/10.1016/ j.redare. 2021.05.010.
9. Altun, D. Atrial Septal Defect Closure via Mini-Thoracotomy in Pediatric Patients: Postoperative Analgesic Effect of Intercostal Nerve Block. Turk Gogus Kalp Dama 2020, 28 (2), 257–263. https://doi.org/10.5606/tgkdc.dergisi.2020.19104.
10. Sahajanandan, R.; Varsha, A.; Kumar, Ds.; Kuppusamy, B.; Karuppiah, S.; Shukla, V.; Thankachen, R. Efficacy of Paravertebral Block in “Fast-Tracking” Pediatric Cardiac Surgery - Experiences from a Tertiary Care Center. Ann Card Anaesth 2021, 24 (1), 24. https://doi.org/10.4103/aca.ACA_83_19.