Pediatric cardiac patients undergoing surgical anesthesia are at an increased risk of poor neurologic outcome (20-50%). Unattenuated anesthetic exposure and pain contributes to physiologic perturbations that may increase neurologic morbidity. Because of the often-large exposure to anesthetic agents in these cardiac children, at such a young age and the potential modifying anesthetic practice that could lead to improved neurodevelopmental outcomes and surgical recovery is paramount. Regional anesthesia such as thoracic epidurals provide effective analgesia and reduced intraoperative anesthetic needed but carry devastating sequelae neurological risks of epidural hematomas after anticoagulation during cardiopulmonary bypass (CPB). Recently, a newly described erector spinae plane block (ESPB) is superficial to neuraxial or vascular structures, providing opportunity to be placed with less risk for surgery requiring CPB. This block has been described as effective regional anesthesia for adult cardiac surgery.
Age range
32 Weeks – 18 Years
Sex
ALL
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Length of Stay (LOS)
Timeframe: Through hospital stay, an average of 5 days
Postoperative Opioid Consumption
Timeframe: Through hospital stay, an average of 5 days
Comparing Changes in EEG Monitoring
Timeframe: Pre-operatively and up to 48 hours prior to discharge
Neurological and Neurobehavioral Testing - Bayley III
Timeframe: 12-48 Months Post-Operatively
Neurological and Neurobehavioral Testing - Capute Scale
Timeframe: 12-48 Months Post-Operatively