Optimizing Peri-Operative Pain Management in Children With Long QT Syndrome and Catecholaminergic Polymorphic Ventricular Tachycardia Undergoing Left Cardiac Sympathetic Denervation: A Case Series on Continuous Erector Spinae Plane Block and Serratus Plane Block
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View abstract on PubMed
Summary
This summary is machine-generated.A multimodal pain management strategy using combined regional anesthesia (Erector Spinae Plane and Serratus Plane blocks) effectively reduced postoperative pain and opioid needs in pediatric patients undergoing VATS-LCSD for long QT syndrome and CPVT.
Area Of Science
- Cardiology
- Anesthesiology
- Pediatric Surgery
Background
- Congenital long QT syndrome (LQTS) and Catecholaminergic Polymorphic Ventricular Tachycardia (CPVT) are inherited arrhythmogenic disorders increasing arrhythmia risk.
- Left cardiac sympathetic denervation (LCSD) via video-assisted thoracoscopic surgery (VATS) is a key treatment for drug-refractory cases.
- Perioperative pain management is a significant challenge in these pediatric patients.
Purpose Of The Study
- To evaluate a multimodal perioperative pain management approach using combined regional anesthesia.
- To assess its impact on postoperative pain scores, opioid requirements, and neuropathic pain incidence.
- Focus on pediatric patients undergoing VATS-LCSD for LQTS and CPVT.
Main Methods
- Retrospective analysis of pediatric patients undergoing VATS-LCSD (2021-March 2025).
- All patients received Erector Spinae Plane (ESP) and Serratus Plane (SP) blocks.
- Continuous local anesthetic infusion via a perifascial catheter following ESP block.
Main Results
- 15 pediatric patients (median age 6.9 years) with LQTS or CPVT were included.
- No major complications; one accidental ESP catheter removal.
- All patients reported VAS pain scores below 2, with no additional opioid or ketorolac use and no neuropathic pain.
Conclusions
- Combined regional anesthesia (ESP and SP blocks) is effective for perioperative pain management in pediatric channelopathy patients undergoing VATS-LCSD.
- This multimodal approach may enhance care quality for this vulnerable population.
- Supports the use of regional anesthesia protocols for improved outcomes.
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