Regional Analgesia in Pediatric Cardiothoracic Surgery: A Bayesian Network Meta-Analysis

Journal of Cardiothoracic and Vascular Anesthesia, Journal Year: 2025, Volume and Issue: unknown

Published: Jan. 1, 2025

Language: Английский

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Regional anesthesia for pediatric cardiac surgery: a review

BMC Anesthesiology, Journal Year: 2025, Volume and Issue: 25(1)

Published: Feb. 15, 2025

Effective pain management in pediatric cardiac surgery is essential for optimizing postoperative outcomes and promoting faster recovery. While intravenous analgesia remains a standard approach, regional anesthesia (RA) techniques have gained attention this population due to their analgesic efficacy, reduced dependence on systemic opioids, enhanced hemodynamic stability. This article provides an overview of current evidence RA surgery. We discuss the role management, outlining various techniques, such as epidural, paravertebral block, fascial plane blocks specific applications, clinical outcomes, challenges posed by anatomy pharmacokinetics. Pain assessment populations complications associated with are also explored. Despite demonstrated efficacy patient group, there need large-scale randomized multicenter studies establish standardized protocols strengthen base its use

Language: Английский

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Regional Anesthesia With Fascial Plane Blocks for Pediatric Cardiac Surgery With Sternotomy: A Narrative Review

Anesthesia & Analgesia, Journal Year: 2025, Volume and Issue: unknown

Published: April 4, 2025

Undertreated pain in children who undergo sternotomy for cardiac surgery can lead to cardiopulmonary complications, the development of chronic pain, and long-term maladaptive stress response. Opioids have dose-dependent side effects that may interfere with postoperative recovery. With increasing availability ultrasound, regional anesthesia is often included multimodal analgesic approaches. Fascial plane blocks targeting intercostal nerves or ventral rami are particular interest patients requiring full heparinization bypass as they avoid manipulation neuraxial noncompressible paravertebral spaces. This narrative review summarizes literature on fascial pediatric undergoing via midline serve a guide clinicians. Both prospective retrospective studies reviewed, prior articles. We describe individual block techniques including transversus thoracic muscle plane, pectointercostal serratus anterior erector spinae provide clinical considerations each block. Additionally, we an analysis stratified by posterior approach type. The majority described examine single-shot blocks; existing catheter literature, which includes catheters, also included. Our findings suggest decrease intraoperative opioid use, scores, time extubation, length stay intensive care unit hospital. Notably, this field small, typically fewer than 100 patients, overall include homogenous patient population, focusing primarily acyanotic congenital heart defects. Nonetheless, despite limitations studies, there substantial evidence support use anesthesia, particularly whom early extubation planned. There need large, multi-center evaluate effectiveness safety specific types, optimal local anesthetic dosing strategies compared active comparators, generalizability results across institutions. Future should consider evaluating role catheters continuous infusion inclusion additional surgical populations, neonates, cyanotic lesions, those longer mechanical ventilation courses.

Language: Английский

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Robot-assisted ultrasound probe calibration for image-guided interventions

International Journal of Computer Assisted Radiology and Surgery, Journal Year: 2025, Volume and Issue: unknown

Published: April 4, 2025

Language: Английский

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Current evidence of ultrasound guided fascial plane blocks for cardiac surgery: a narrative literature review

Korean journal of anesthesiology, Journal Year: 2022, Volume and Issue: unknown

Published: Oct. 17, 2022

Fascial plane blocks are useful for multimodal analgesia after cardiac surgery since they can provide effective without the serious risks associated with conventional techniques such as neuraxial hematoma and pneumothorax. This narrative review covers performed at parasternal intercostal, interpectoral, pectoserratus, serratus anterior, erector spinae, retrolaminar planes, which targets fascial in surgery. Brief anatomical considerations, mechanisms, currently available evidence reviewed. Additionally, recent on subcutaneous-implantable cardioverter-defibrillator implantation also Keywords: Analgesia; Cardiac surgical procedures; Fascia; Implantable defibrillators; Nerve block; Postoperative pain; Thoracic wall.

Language: Английский

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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

Journal of Cardiothoracic and Vascular Anesthesia, Journal Year: 2023, Volume and Issue: 37(9), P. 1726 - 1733

Published: May 15, 2023

Language: Английский

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Retrolaminar block for opioid-free anaesthesia and enhanced recovery after posterior lumbar discectomy: A randomised controlled study

Indian Journal of Anaesthesia, Journal Year: 2024, Volume and Issue: 68(3), P. 261 - 266

Published: Feb. 22, 2024

Background and Aims: Intraoperative regional analgesia enhanced recovery are standard care models aimed at reducing perioperative opioid use following spine surgeries. This study to examine the analgesic effect of retrolaminar block in promoting pain relief after posterior lumbar discectomy. Methods: The patients undergoing elective discectomy were randomised into group (n = 36) (received an intra-operative bilateral with 15 mL bupivacaine 0.25%, 2 (8 mg) dexamethasone, magnesium sulphate 10% (200 on each side) control general anaesthesia). Primary outcomes time (time from isoflurane discontinuation first response verbal command) discharge admission post-anaesthesia unit (PACU) PACU, when Aldrete score was ≥9). P values < 0.05 considered statistically significant. Results: extubation, recovery, times significantly shorter compared ( 0.001). Postoperative scores lower for up 8 h only administration ketorolac post-operatively longer total consumption reduced Conclusion: Intra-operative is easy effective opioid-free anaesthesia technique that improves

Language: Английский

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Forgotten pioneers of erector spinae plane block: historical digression

Regional Anesthesia and Acute Pain Management, Journal Year: 2023, Volume and Issue: 17(2), P. 89 - 99

Published: Aug. 5, 2023

One of the newest methods interfacial blocks is erector spinae plane (ESP) block, which considered to have been first described by Forero in 2016. Given its simplicity and safety, ESP block used for postoperative analgesia during surgery on abdominal organs, chest, breast, spine treatment chronic pain. This study aimed describe historical aspects origin blockade back-straightening muscles possibilities application clinical practice. Articles published from January 2023 April PubMed (MEDLINE), Cochrane Library, RSCI databases were searched two independent researchers. The date last search was 10, 2023. A total 546 studies identified, 68 included review. Analysis synthesis construct conclusion based information obtained. history began 1994 when Professor B.M. Rachkov V.M. Kustov received a patent Method pain pathology spinal cord column. technique proposed M. nearly identical RachkovKustov method with respect direction needle insertion injection site local anesthetic solution. mechanism action has not definitively established. Data possible complications side effects are presented. Therefore, we every reason state that Russian scientists discovered Canadian Forero. Further needed determine specific indications evidence efficacy comparison other regional anesthesia.

Language: Английский

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Regional analgesia for cardiac surgery

Current Opinion in Anaesthesiology, Journal Year: 2022, Volume and Issue: 35(5), P. 605 - 612

Published: July 27, 2022

Purpose of review Regional anesthesia is gaining attention as a valuable component multimodal, opioid-sparing analgesia in cardiac surgery, where improving the patient's quality recovery while minimizing harms opioid administration are key points emphasis perioperative care. This serves an outline recent advancements variety applications regional for surgery. Recent findings Growing interest analgesia, particularly use newer “chest wall blocks”, has led to accumulating evidence efficacy multiple techniques These include technical approaches, with results consistently demonstrating optimized pain control and reduced requirements. management experts have worked derive consensus around nerve block nomenclature, which will be foundational establish best practice, design report future research consistently, improve medical education, generally advance our knowledge this vital area patient Summary The field surgery matured over last several years. A been described shown efficacious part approach surgical setting.

Language: Английский

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The value of the peroneus brevis tendon cross-sectional area in early diagnosing of peroneus brevis tendinitis: The peroneus brevis tendon cross-sectional area

Medicine, Journal Year: 2022, Volume and Issue: 101(43), P. e31276 - e31276

Published: Oct. 28, 2022

A thickened peroneus brevis tendon has been considered to be an important morphologic parameter of tendinitis (PBT). Previous researchers have found that the thickness (PBTT) is correlated with inflammation tendon. However, inflammatory hypertrophic change different from simple thickness. Thus, we devised cross-sectional area (PBTCSA) as a new diagnostic analyze hypertrophy whole PBT. We assumed PBTCSA major useful for early PBT diagnosis. Peroneus images were collected 22 patients and normal subjects who underwent ankle-magnetic resonance imaging revealed no evidence The T1-weighted axial evaluated at ankle level all participants. PBTT was measured thickest point transverse image ligament most hypertrophied in A-MR images. average 2.22 ± 0.29 mm group 2.85 0.36 group. 6.98 1.54 mm2 13.11 2.45 had significantly greater (P < .001) than did. receiver operating characteristic curve analysis suitable cutoff value 2.51 mm, 81.8% sensitivity specificity, AUC score 0.93. 10.08 mm2, 90.9% 0.98. Even though both associated PBT, more sensitive parameter.

Language: Английский

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