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May 1, 2000Anesthesia & Analgesia

Neuraxial Blockade for Pediatric Cardiac Surgery: Lessons Yet to Be Learned

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Why the study?

Does neuraxial blockade provide superior benefits and acceptable safety compared to standard IV analgesia in pediatric patients undergoing cardiac surgery?

Population

Pediatric patients undergoing cardiac surgery for congenital heart disease

Comparison

Regional anesthetic techniques vs Standard IV analgesic methods

Design

Editorial

Authors

JSJames M. StevenChildren's Hospital of PhiladelphiaFMFrancis X. McGowanChildren's Hospital of Philadelphia

Discussion

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Implication

Despite reports of safety in small retrospective series, the routine use of neuraxial blockade in pediatric cardiac surgery lacks comparative evidence of superior benefit over standard IV analgesia to justify the potential risks.

Structured PICO

Does neuraxial blockade provide superior benefits and acceptable safety compared to standard IV analgesia in pediatric patients undergoing cardiac surgery?

P
Population
Pediatric patients undergoing cardiac surgery for congenital heart disease
I
Intervention
Regional anesthetic techniques (neuraxial blockade, epidural or subarachnoid puncture)
C
Comparator
Standard IV analgesic methods
O
Outcome
Efficacy and safety (specifically risk of epidural hematoma and paraplegia)safety

Despite reports of safety in small retrospective series, the routine use of neuraxial blockade in pediatric cardiac surgery lacks comparative evidence of superior benefit over standard IV analgesia to justify the potential risks.

Limitations

  • Absence of comparative data demonstrating extraordinary benefits
  • Small sample sizes in existing retrospective series are insufficient to detect low frequency/high morbidity occurrences such as paraplegia or epidural hematoma

Cite This Study

Steven et al. (2000) studied this question.

synapsesocial.com/papers/6a8c292ffe910689a2894614https://doi.org/10.1097/00000539-200005000-00001

Topics

Congenital heart disease adults
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Thoracic epidural analgesia in aortocoronary bypass surgery II: effects on the endocrine metabolic response1994 · 105 citations
  2. 2A Report of Two Hundred Twenty Cases of Regional Anesthesia in Pediatric Cardiac Surgery2000 · 138 citations
  3. 3A Retrospective Examination of Regional Plus General Anesthesia in Children Undergoing Open Heart Surgery2000 · 100 citations
  4. 4Halothane–Morphine Compared with High-Dose Sufentanil for Anesthesia and Postoperative Analgesia in Neonatal Cardiac Surgery1992 · 858 citations
  5. 5If Nothing Goes Wrong, Is Everything All Right?1983 · 1,050 citations