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小儿心脏手术的区域麻醉:综述

Regional anesthesia for pediatric cardiac surgery: a review.

作者信息

Dost Burhan, De Cassai Alessandro, Amaral Sara, Balzani Eleonora, Karapinar Yunus Emre, Beldagli Müzeyyen, Yalin Mirac Selcen Ozkal, Turunc Esra, Ahiskalioglu Ali, Tulgar Serkan

机构信息

Department of Anesthesiology and Reanimation, Faculty of Medicine, Ondokuz Mayis University, Samsun, TR55139, Türkiye.

Institute of Anesthesia and Intensive Care Unit, University Hospital of Padua, Padua, Italy.

出版信息

BMC Anesthesiol. 2025 Feb 15;25(1):77. doi: 10.1186/s12871-025-02960-z.

Abstract

BACKGROUND

Effective pain management in pediatric cardiac surgery is essential for optimizing postoperative outcomes and promoting faster recovery. While intravenous analgesia remains a standard approach, regional anesthesia (RA) techniques have gained attention in this population due to their analgesic efficacy, reduced dependence on systemic opioids, and enhanced hemodynamic stability.

MAIN BODY

This article provides an overview of current evidence of RA techniques for pediatric cardiac surgery. We discuss the role of RA in pediatric pain management, outlining various techniques, such as epidural, paravertebral block, fascial plane blocks and their specific applications, clinical outcomes, and the challenges posed by pediatric anatomy and pharmacokinetics. Pain assessment in pediatric populations and the complications associated with RA are also explored.

CONCLUSION

Despite the demonstrated efficacy of RA in this patient group, there is a need for large-scale randomized multicenter studies to establish standardized protocols and strengthen the evidence base for its use in pediatric cardiac surgery.

摘要

背景

小儿心脏手术中有效的疼痛管理对于优化术后结果和促进更快恢复至关重要。虽然静脉镇痛仍然是一种标准方法,但区域麻醉(RA)技术因其镇痛效果、减少对全身性阿片类药物的依赖以及增强血流动力学稳定性而在这一人群中受到关注。

正文

本文概述了小儿心脏手术中RA技术的当前证据。我们讨论了RA在小儿疼痛管理中的作用,概述了各种技术,如硬膜外麻醉、椎旁阻滞、筋膜平面阻滞及其具体应用、临床结果以及小儿解剖学和药代动力学带来的挑战。还探讨了小儿群体的疼痛评估以及与RA相关的并发症。

结论

尽管RA在该患者群体中已显示出疗效,但仍需要大规模随机多中心研究来建立标准化方案,并加强其在小儿心脏手术中应用的证据基础。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e4ae/11829357/07b490ee6446/12871_2025_2960_Fig1_HTML.jpg

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