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Peripheral Regional Anesthesia Techniques in Pediatric Cardiac Surgery: A Scoping Review
Kumi Kataoka1, Subin Park2, Darshan Shingala3
1Department of Anesthesia and Pain Medicine, The Hospital for Sick Children, Toronto, ON, Canada; Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
Journal of Cardiothoracic and Vascular Anesthesia
|January 16, 2026
Summary
Peripheral regional anesthesia (PRA) improves outcomes for pediatric cardiac surgery patients. This technique reduces opioid use, speeds extubation, and shortens ICU stays with a good safety profile.
Area of Science:
- Anesthesiology and Perioperative Medicine
- Pediatric Cardiac Surgery
- Regional Anesthesia
Background:
- Peripheral regional anesthesia (PRA) is increasingly used in multimodal analgesia and enhanced recovery.
- Evidence on PRA in pediatric cardiac surgery needs synthesis to guide clinical practice.
Purpose of the Study:
- To conduct a scoping review of PRA use in pediatric patients undergoing cardiac surgery.
- To answer 10 research questions regarding PRA efficacy and safety in this population.
Main Methods:
- Adherence to PRISMA-ScR guidelines for scoping reviews.
- Searched 6 databases and trial registries up to August 2025.
- Included RCTs of pediatric patients (<18 years) undergoing cardiac surgery with PRA; performed post hoc screening for meta-analyses.
Main Results:
- 29 RCTs identified 11 PRA techniques; 5 meta-analyses were also found.
- PRA reduced intraoperative/postoperative opioid consumption, expedited extubation, and decreased ICU length of stay.
- Pain scores were lower 8-24 hours postoperatively; PRA-related complications were rare and similar to placebo.
Conclusions:
- Peripheral regional anesthesia enhances perioperative outcomes in pediatric cardiac surgery.
- PRA offers opioid-sparing effects, earlier extubation, and shorter ICU stays with a favorable safety profile.
- Further research is needed to standardize dosing and optimize block selection.
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