Transversus Thoracic Muscle Plane Block for Analgesia After Pediatric Cardiac Surgery

Abstract

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. A retrospective study. A tertiary care teaching hospital. Children who underwent congenital heart surgery through median sternotomy between January 2018 and March 2019. 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). TTPB appeared to be an effective technique for postoperative analgesia in pediatric patients undergoing cardiac surgery using a median sternotomy approach.