Ultrasound Guided Bilateral Pectoral Nerve Block Versus Bilateral Transverse Thoracic Plane Block In Pediatric Patients Undergoing Corrective Cardiac Surgeries Requiring Cardiopulmonary Bypass Via Median Sternotomy
Egypt81 participantsStarted 2024-09-30
Plain-language summary
This randomized, double-blinded, study aims to compare the efficacy of intraoperative and postoperative pain control while using bilateral ultrasound guided the pectoral nerves (PECS) versus transversus thoracic muscle plane block (TTPB) in pediatric patients undergoing corrective cardiac surgeries.
Who can participate
Age range6 Months ā 7 Years
SexALL
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Inclusion Criteria:
* Age: 6 months - 7 years.
* Gender: both sexs .
* Risk Adjustment for Congenital Heart Surgery (RACHS) II and III.
* Patients undergoing cardiac surgeries requiring cardiopulmonary bypass with midline sternotomy incision.
Exclusion Criteria:
* Patients whose parents or legal guardians refuse to participate.
* Preoperative mechanical ventilation.
* Patients in coma, mental retardation, neurological disease, or on drugs affecting the behaviour.
* Preoperative inotropic drug infusion.
* (Bleeding disorders (drug induced i.e., coumadin; or genetic e.g. hemophilia; or acquired e.g. disseminated intravascular coagulation \[DIC\]), coagulopathy: Partial Thromboplastin Time (PTT) \> 40 seconds, International Normalized Ratio (INR) \> 1.4, platelet count \< 100x10ā¹.
* Known or suspected allergy to any of the studied drugs.
* Severe pulmonary hypertension (mean resting blood pressure in pulmonary arteries is above 70mmHg).
* Cardiopulmonary bypass time more than 90 minutes.
* local infection.
* Significant Renal impairment (creatinine more than 1.2mg/dl)
* Aortic cross-clamp time more than 45 minutes.
* Total time from induction till intensive Care Unit (ICU) transfer more than 4 hours and 30 mins.