Analgesic Efficacy of Ultrasound-guided Bilateral Pecto-intercostal Plane Block in Pediatric Cardiac Surgery

Başakşehir Çam & Sakura City Hospital82 enrolled

Overview

The goal of this study is to compare patients outcome in two groups. the first group will be applied pecto-intercostal fascial block additional to general anesthesia and the second group will not. This is a single-center, prospective, observational trial to study the efficacy of Pecto-intercostal Fascial Block (PIFB) in patients undergoing pediatric congenital cardiac surgery requiring median sternotomy and cardiopulmonary bypass. The children are aged between 6 months to 12 years with American Society of Anesthesiologists (ASA) score 2 or 3. The main question it aims to answer are: The investigators' first question is if applying pecto-intercostal fascial block just after anesthesia induction reduces postoperative pain status. Secondly, if this pain status makes any reduction in preoperative opioid consumption. The investigators aim to find out; if there is any difference in opioid consumption during operation and postoperative 24-hour, postoperative Face, Legs, Activity, Cry, Consolability (FLACC) scale, length of intensive care unit and hospital stays, and other complications.

Study Type

OBSERVATIONAL

Enrollment

Conditions

Regional Anesthesia

Eligibility

Sex: ALLMin age: 6 MonthsMax age: 12 Years

Medical Language ↔ Plain English

Inclusion Criteria: * patients undergoing pediatric congenital cardiac surgery requiring median sternotomy and cardiopulmonary bypass. * age between 6 months and 12 years * ASA score 2 or 3 * Risk Adjustment for Congenital Heart Surgery (RACHS-1) score under 4 Exclusion Criteria: * patients who need mechanical ventilation support before surgery * patients who need to stay intubated more than 24 hours after surgery * patients undergo complex cardiac surgery with RACHS-1 score higher than 4. * patients without consent * having allergic reaction to bupivacaine * having cardiac surgery before (redo patient)

Outcomes

Primary Outcomes

Pain Score

Face, Legs, Activity, Cry, Consolability scale (FLACC scale), FLACC is a behavioral pain assessment scale used for nonverbal or preverbal patients who are unable to self-report their level of pain. Pain is assessed through observation of 5 categories including face, legs, activity, cry, and consolability. The values are between 0 and 10. The higher the score the worse the pain and outcome.

Time frame: at the time of extubation, 1st hour after extubation, 2nd hour after extubation, 6th hour after extubation, 12th hour after extubation, 24th hour after extubation

Secondary Outcomes

peroperative opioid consumption

sum of fentanyl and remifentanil consumption in micrograms

Time frame: during operation

Postoperative opioid consumption

morphine usage in milligrams

Time frame: From extubation to 24 hours after extubation.

dexmedetomidine consumption

dexmedetomidine in micrograms

Time frame: From the beginning of dexmedetomidine infusion to 24 hours after extubation

Paracetamol consumption

paracetamol in milligrams