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Efficacy of paravertebral block in “Fast-tracking” pediatric cardiac surgery - Experiences from a tertiary care center

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...

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Autores principales: Sahajanandan, Raj, Varsha, A V, Kumar, D Sathish, Kuppusamy, Balaji, Karuppiah, Sathappan, Shukla, Vinayak, Thankachen, Roy
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer - Medknow 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8081147/
https://www.ncbi.nlm.nih.gov/pubmed/33938827
http://dx.doi.org/10.4103/aca.ACA_83_19
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author Sahajanandan, Raj
Varsha, A V
Kumar, D Sathish
Kuppusamy, Balaji
Karuppiah, Sathappan
Shukla, Vinayak
Thankachen, Roy
author_facet Sahajanandan, Raj
Varsha, A V
Kumar, D Sathish
Kuppusamy, Balaji
Karuppiah, Sathappan
Shukla, Vinayak
Thankachen, Roy
author_sort Sahajanandan, Raj
collection PubMed
description 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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spelling pubmed-80811472021-06-02 Efficacy of paravertebral block in “Fast-tracking” pediatric cardiac surgery - Experiences from a tertiary care center Sahajanandan, Raj Varsha, A V Kumar, D Sathish Kuppusamy, Balaji Karuppiah, Sathappan Shukla, Vinayak Thankachen, Roy Ann Card Anaesth Original Article 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. Wolters Kluwer - Medknow 2021 2021-01-22 /pmc/articles/PMC8081147/ /pubmed/33938827 http://dx.doi.org/10.4103/aca.ACA_83_19 Text en Copyright: © 2021 Annals of Cardiac Anaesthesia https://creativecommons.org/licenses/by-nc-sa/4.0/This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.
spellingShingle Original Article
Sahajanandan, Raj
Varsha, A V
Kumar, D Sathish
Kuppusamy, Balaji
Karuppiah, Sathappan
Shukla, Vinayak
Thankachen, Roy
Efficacy of paravertebral block in “Fast-tracking” pediatric cardiac surgery - Experiences from a tertiary care center
title Efficacy of paravertebral block in “Fast-tracking” pediatric cardiac surgery - Experiences from a tertiary care center
title_full Efficacy of paravertebral block in “Fast-tracking” pediatric cardiac surgery - Experiences from a tertiary care center
title_fullStr Efficacy of paravertebral block in “Fast-tracking” pediatric cardiac surgery - Experiences from a tertiary care center
title_full_unstemmed Efficacy of paravertebral block in “Fast-tracking” pediatric cardiac surgery - Experiences from a tertiary care center
title_short Efficacy of paravertebral block in “Fast-tracking” pediatric cardiac surgery - Experiences from a tertiary care center
title_sort efficacy of paravertebral block in “fast-tracking” pediatric cardiac surgery - experiences from a tertiary care center
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8081147/
https://www.ncbi.nlm.nih.gov/pubmed/33938827
http://dx.doi.org/10.4103/aca.ACA_83_19
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