Regional anesthesia and pediatric cardiac surgery

Abstract

Treatment of pain after cardiac surgery is the subject of a growing number of publications and presentations because of the current trend toward “fast-track” management. Tracheal extubation in the operating room or within a few hours of admission to the intensive care unit has become common practice after the repair of simple cardiac defects. This precludes the use of large doses of systemic opioids during and after surgery because of resultant respiratory depression. A multimodal approach to the treatment of postoperative pain is therefore required. The use of regional anesthesia in combination with general anesthesia for children undergoing cardiac surgery has been reported to facilitate early tracheal extubation and provide analgesia after cardiac surgery in children. In this article, the benefits and risks of regional anesthesia in infants and children having open heart surgery are reviewed. In addition, specific techniques in use are described. Copyright 2002, Elsevier Science (USA). All rights reserved.