Local and Regional Anesthesia (Feb 2023)

Postoperative Outcomes of Analgesic Management with Erector Spine Plane Block at T5 Level in Pediatric Patients Undergoing Cardiac Surgery with Sternotomy: A Cohort Study

  • Cruz-Suárez GA,
  • Rebellón Sánchez DE,
  • Torres-Salazar D,
  • Arango Sakamoto A,
  • López-Erazo LJ,
  • Quintero-Cifuentes IF,
  • Vélez-Esquivia MA,
  • Jaramillo-Valencia SA,
  • Suguimoto-Erasso AJT

Journal volume & issue
Vol. Volume 16
pp. 1 – 9

Abstract

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Gustavo A Cruz-Suárez,1,2 David E Rebellón Sánchez,3,4 Daniela Torres-Salazar,2 Akemi Arango Sakamoto,4 Leidy Jhoanna López-Erazo,1,2 Iván F Quintero-Cifuentes,1,2 María A Vélez-Esquivia,2 Sergio A Jaramillo-Valencia,1 Antonio JT Suguimoto-Erasso1,2 1Fundación Valle del Lili, Anesthesiology Department, Cali, 760032, Colombia; 2Universidad Icesi, Facultad de Ciencias de la Salud, Departamento de Ciencias Clínicas, Cali, Colombia; 3Centro Internacional de Entrenamiento e Investigaciones Médicas (CIDEIM), Universidad Icesi, Cali, Colombia; 4Fundación Valle del Lili, Centro de Investigaciones Clínicas, Cali, 760032, ColombiaCorrespondence: Gustavo A Cruz-Suárez, Fundación Valle del Lili, Anesthesiology Department, Cra. 98 # 18-49, Cali, 760032, Colombia, Tel +576023319090; Ext 4022, Email [email protected]: There is limited evidence on the impact of erector spinae plane block (ESPB) as part of multimodal analgesia in pediatric population undergoing cardiac surgery.Methods: A retrospective cohort study was conducted in patients under 18 years of age, who underwent cardiac surgery Risk Adjusted classification for Congenital Heart Surgery (RACHS-1) ≤ 3 by sternotomy. The study aims to evaluate the effect of ESPB as part of multimodal analgesia in pediatric patients undergoing cardiac surgery compared to conventional analgesia (CA) on relevant clinical outcomes: length of hospital stay, length of ICU stay, opioid consumption, time to extubation, mortality, and postoperative complications. The participants included were treated in a reference hospital in Colombia from July 2019 to June 2022.Results: Eighty participants were included, 40 in the ESPB group and 40 in the CA group. There was a significant decrease (Log rank test p = 0.007) in days to length of hospital stay in ESPB group (median 6.5 days (IQR: 4– 11)) compared to the CA group (median 10.5 days (IQR: 6– 25)). Likewise, there was a higher probability of discharge from the ICU in the ESPB group (HR 1.71 (95% CI: 1.05– 2.79)). The ESPB group had lower opioid consumption (p < 0.05). There were no differences in time to extubation, mortality, and postoperative complications.Conclusion: ESPB as part of multimodal analgesia in pediatric patients undergoing cardiac surgery is feasible and associated with shorter hospital length of stay, faster ICU discharge and lower opioid consumption.Keywords: erector spinae plane block, cardiac surgery procedures, pediatric age group, anesthesia, perioperative, pediatric anesthesia

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