Objective
The objective of this study was to assess the effectiveness of transversus thoracic
muscle plane block (TTPB) as a novel technique for postoperative analgesia in pediatric
cardiac surgery.
Design
A retrospective study.
Setting
A tertiary care teaching hospital.
Participants
Children who underwent congenital heart surgery through median sternotomy between
January 2018 and March 2019.
Interventions
Bilateral ultrasound-guided TTPB was performed as a single-shot technique before the
sternal incision. A total dose of bupivacaine 0.25% (0.5 ml/kg) was injected between
the fourth and fifth ribs just lateral to the sternum. Patients who received TTPB
were designated as the TTPB group, and the other group was named the non-TTPB group
Measurements and Main Results
Thirty-three patients underwent intraoperative bilateral TTPB before the sternal incision
and 37 did not. The groups were comparable as for demographic and intraoperative clinical
characteristics. Pain scores were significantly lower in the TTPB group compared with
the non-TTPB group (p < 0.001). Intraoperatively, non-TTPB patients received significantly
higher doses of fentanyl (p < 0.001). Moreover, the total fentanyl dose during a 24-hour
period was also higher in the non-TTPB group (p < 0.001). The time to extubation was
significantly lower in the TTPB group than in the non-TTPB group (p < 0.001).
Conclusions
TTPB appeared to be an effective technique for postoperative analgesia in pediatric
patients undergoing cardiac surgery using a median sternotomy approach.
Key Words
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Article Info
Publication History
Published online: August 11, 2020
Identification
Copyright
© 2020 Elsevier Inc. All rights reserved.
