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Transversus Thoracic Muscle Plane Block For Postoperative Pain in Pediatric Cardiac Surgery: A Systematic Review And

Yi-Yang Cui1, Zi-Qing Xu2, Huai-Jing Hou2

  • 1First School of Clinical Medicine, Gansu University of Chinese Medicine, Chengguan District, Lanzhou, China.

Journal of Cardiothoracic and Vascular Anesthesia
|March 7, 2024
PubMed

Insights

Transversus thoracic muscle plane block (TTMPB) may reduce pain, opioid use, and intensive care unit (ICU) stay in pediatric cardiac surgery patients. This novel block offers potential benefits for managing surgical pain in children.

Area of Science:

  • Anesthesiology and Pain Management
  • Pediatric Cardiac Surgery
  • Regional Anesthesia Techniques

Background:

  • Pediatric cardiac surgery often involves significant postoperative pain, impacting recovery.
  • Effective analgesia is crucial to prevent a pain continuum into the postoperative period.
  • The efficacy of Transversus Thoracic Muscle Plane Block (TTMPB) for pediatric cardiac surgery pain is not well-established.

Approach:

  • A systematic review and meta-analysis was performed.
  • Searched major databases (PubMed, Embase, Web of Science, CENTRAL, WanFang, CNKI) up to November 2023.
  • Evaluated evidence certainty using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach.

Key Points:

  • Six studies with 601 pediatric patients (2 months to 12 years) were analyzed.
  • TTMPB demonstrated potential reductions in postoperative pain scores at 12 and 24 hours.
  • Significant decreases were observed in intraoperative and postoperative opioid consumption.
  • Reduced intensive care unit (ICU) length of stay and extubation time were noted.
  • Evidence certainty ranged from very low to low.

Conclusions:

  • TTMPB shows promise in improving pain management for pediatric cardiac surgery.
  • The technique may decrease opioid requirements and shorten ICU stays.
  • Further high-quality research is needed to confirm these findings due to low evidence certainty.
Abstract

Keywords:
cardiac surgerylocal anesthesiameta-analysisopioid analgesicspostoperative paintransversus thoracic muscle plane block

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