Pain Management of Pecto-intercostal Fascial Block Versus Intravenous Fentanyl after Pediatric Cardiac Surgery

Abstract

Study objective: The intent of this investigation is to ascertain the usefulness of pectointercostal fascial block in decreasing intraoperative opioids consumption in non-cyanotic pediatric patients undergoing elective cardiac surgery. Secondary objectives include intra - operative hemodynamic reaction to stress surgical stimuli. Design: a single blinded, prospective, randomized, controlled trial study.
Setting: Mansoura university children hospital (MUCH).
Patients: Intravenous fentanyl (control group) (n=40): Patients received only intravenous fentanyl analgesia. Pecto intercostal fascial block group (experimental group) (n=40): Cases underwent 0.3 mL/kg bupivacaine 0.25% with an optimum dose of 2 mg/kg that was injected into pecto-intercostal space.
Measurements and main results: show that significant lower pain score among group with Pecto-intercostal group than control group at 2, 6, 12, 18 & 24 hours without statistically significant difference at 1 hour .Comparing pain score within each group with 1 hour shows statistically significant decrease during follow up and show that there is statistically significant higher total intraoperative consumption fentanyl among control than Pecto-intercostal group (145 versus 70) and statistically significant higher total postoperative 24 hours fentanyl consumption among control than pecto-intercostal group (100 versus 50 mic).
Conclusions: We might then assume that using a single shot PIFB in children enduring cardiac operation via median sternotomy is connected with stable intraoperative hemodynamics, lower perioperative opioid analgesic necessities, and reduced pain severity in the 1st twenty four hours after surgery.