Key result
Single-shot paravertebral block in pediatric cardiac surgery significantly reduced median time to extubation compared to historical controls (0 hrs vs 16 hrs; P=0.017).
Why the study?
Paravertebral block is increasingly used as an alternative to epidural and caudal analgesia, but data regarding its efficacy and safety in pediatric cardiac surgery remain scarce.
Does single shot paravertebral block reduce time to extubation and analgesia requirements in pediatric patients undergoing cardiac surgery?
Cohort (n=200)
No
Does single shot paravertebral block reduce time to extubation and analgesia requirements in pediatric patients undergoing cardiac surgery?
Absolute Event Rate: 0% vs 16%
p-value: p=0.017
Single shot paravertebral block significantly reduces time to extubation, opioid requirements, and postoperative pain in pediatric patients undergoing cardiac surgery, facilitating fast-track care.
May support earlier extubation in pediatric cardiac surgery; hypothesis-generating and requires randomized confirmation before practice change.
Introduction: Fast tracking plays a crucial role in reducing perioperative morbidity and financial burden by facilitating early extubation and discharge from hospital. Paravertebral block (PVB) is becoming more popular in paediatric surgeries as an alternative to epidural and caudal analgesia. There is scarcity of data regarding the efficacy and safety of PVB in paediatric cardiac surgery. Methods: We performed a review of records of paediatric cardiac patients who underwent cardiac surgery under general anaesthesia with single shot PVB and compared the analgesia and postoperative outcomes with matched historical controls who underwent cardiac surgery with same anaesthesia protocol without PVB. Results: The data from 200 children were analysed. 100 children who received paravertebral block were compared with a matched historical controls. The median time to extubation was shorter in the PVB group (0 hr, IQR 0-3 hrs) compared to the control group (16 hrs, IQR 4-20 hrs) (P value 0.017*). Intraoperative and postoperative fentanyl requirement was much lower in the PVB group (3.49 (0.91)) compared to the control group (9.86 (1.37)) P value <0.01*. Time to first rescue dose of analgesic was longer (7 hrs vs 5 hrs, P 0.01*), while time to extubation and duration of ICU stay were significantly less in PVB group . Mean postoperative pain scores were significantly lower in the PVB group at the time of ICU admission (0.85 vs 3.12, P 0.001*) till 4 hours (2.11 vs 3.32, P 0.001*). Conclusion: PVB provides an effective and safe anaesthetic approach which can form an important component of "fast-track" care in paediatric cardiac surgery.
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Sahajanandan et al. (2021) conducted a cohort in Paediatric cardiac surgery (n=200). Single shot paravertebral block (PVB) vs. Matched historical controls without PVB was evaluated on Median time to extubation (hours) (p=0.017). Single-shot paravertebral block in pediatric cardiac surgery significantly reduced median time to extubation compared to historical controls (0 hrs vs 16 hrs; P=0.017).
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