Parasternal Nerve Block Using Bupivacaine for Postoperative Analgesia in Children Undergoing Cardiac Surgery
| Status: | Completed |
|---|---|
| Conditions: | Chronic Pain |
| Therapuetic Areas: | Musculoskeletal |
| Healthy: | No |
| Age Range: | Any - 17 |
| Updated: | 8/24/2018 |
| Start Date: | April 2014 |
| End Date: | November 2015 |
Parasternal Nerve Block Using Bupivacaine for Postoperative Analgesia in Children Undergoing Cardiac Surgery: A Prospective: Double-Blind, Randomized Controlled Trial
All pediatric patients who undergo cardiac surgery require analgesic medications for
postoperative pain control and many require sedation to facilitate comfort with cares.
Parasternal infiltration of local anesthetic for nerve blocks is a simple option to
postoperative analgesia. The investigators hypothesize that Bupivacaine, a parasternal nerve
block administered in pediatric patients undergoing cardiac surgery will reduce the
requirement of Opioids and other pain medications as well as decrease postoperative pain
scores. This is a prospective, double-blind, randomized controlled trial. Subjects are
randomized to receive either 0.25% Bupivacaine or normal saline following their
cardiothoracic surgery.
postoperative pain control and many require sedation to facilitate comfort with cares.
Parasternal infiltration of local anesthetic for nerve blocks is a simple option to
postoperative analgesia. The investigators hypothesize that Bupivacaine, a parasternal nerve
block administered in pediatric patients undergoing cardiac surgery will reduce the
requirement of Opioids and other pain medications as well as decrease postoperative pain
scores. This is a prospective, double-blind, randomized controlled trial. Subjects are
randomized to receive either 0.25% Bupivacaine or normal saline following their
cardiothoracic surgery.
One of the most challenging struggles in clinical practices in pediatric cardiac intensive
care units is the provision of optimal and safe postoperative analgesia and sedation. All
pediatric patients who undergo cardiac surgery require analgesic medications for
postoperative pain control and many require sedation to facilitate comfort with cares.
Parasternal infiltration of local anesthetic for nerve blocks is a simple option to
postoperative analgesia. Bupivacaine is a local anesthetic that can be injected into the
intercostal spaces on each side of a sternotomy to induce nerve block.
The purpose of this study is to evaluate whether the use of Bupivacaine as a nerve block in
children undergoing cardiothoracic surgery will reduce postoperative pain medication use and
decrease postoperative pain scores. The investigators hypothesize that the administration of
Bupivacaine bilaterally into the posterior intercostal spaces on each side of a sternotomy
following cardiothoracic surgery will reduce the requirement of pain medications as well as
decrease postoperative pain scores.
This is a prospective, randomized, double-blind, control study. Subjects are randomized into
two arms: those who receive 0.25% Bupivacaine and those who receive placebo (normal saline).
Subjects receive 1 milliliter per kilogram up to 20 kilograms, then 0.5 milliliters per
kilogram up to 50 kilograms of study drug.
Subjects are followed for 5 days postoperatively, then on day of discharge. Pain medication
administered and Face, Legs, Activity, Cry, and Consolability (FLACC) scores are recorded
daily for 5 days.
care units is the provision of optimal and safe postoperative analgesia and sedation. All
pediatric patients who undergo cardiac surgery require analgesic medications for
postoperative pain control and many require sedation to facilitate comfort with cares.
Parasternal infiltration of local anesthetic for nerve blocks is a simple option to
postoperative analgesia. Bupivacaine is a local anesthetic that can be injected into the
intercostal spaces on each side of a sternotomy to induce nerve block.
The purpose of this study is to evaluate whether the use of Bupivacaine as a nerve block in
children undergoing cardiothoracic surgery will reduce postoperative pain medication use and
decrease postoperative pain scores. The investigators hypothesize that the administration of
Bupivacaine bilaterally into the posterior intercostal spaces on each side of a sternotomy
following cardiothoracic surgery will reduce the requirement of pain medications as well as
decrease postoperative pain scores.
This is a prospective, randomized, double-blind, control study. Subjects are randomized into
two arms: those who receive 0.25% Bupivacaine and those who receive placebo (normal saline).
Subjects receive 1 milliliter per kilogram up to 20 kilograms, then 0.5 milliliters per
kilogram up to 50 kilograms of study drug.
Subjects are followed for 5 days postoperatively, then on day of discharge. Pain medication
administered and Face, Legs, Activity, Cry, and Consolability (FLACC) scores are recorded
daily for 5 days.
Inclusion Criteria:
- Age 0-17 years old at time of surgery
- Society of Thoracic Surgeons- European Association for Cardio-Thoracic Surgery (STAT)
mortality categories 1-3
- Surgical intervention requiring median sternotomy
- Expected extubation within 24 hours of surgery
Exclusion Criteria:
- Known allergic reaction or hypersensitivity to Bupivacaine or to any local anesthetic
agent of the amide type
- Delayed sternum closure
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