Bilateral Two Levels Serratus Anterior Plane Block in Pediatric Cardiac Surgery With Median Sternotomy

Launched by CAIRO UNIVERSITY · Jan 22, 2024

Keywords

ClinConnect Summary

This clinical trial is studying a new way to manage pain for children undergoing heart surgery, specifically those with congenital heart disease. The researchers are testing a technique called the bilateral two-level serratus anterior plane block (SAPB), which is designed to provide effective pain relief during and after surgery. This method has been used in adults but is being explored for its effectiveness in pediatric patients who need corrective heart surgery through a method called median sternotomy (which involves making an incision down the middle of the chest).

To participate in this trial, children aged 6 months to 18 years who are undergoing certain types of heart surgeries may be eligible, especially those classified as low to moderate risk. However, some children may not qualify, such as those with certain heart conditions, allergies to anesthesia, or other significant medical issues. If they join the trial, participants will receive the SAPB along with their usual care, and the team will closely monitor their pain levels and overall recovery. This trial aims to find a safer and more effective way to manage pain in young patients after heart surgery.

Gender

ALL

Eligibility criteria

• Inclusion Criteria:
• • Risk Adjustment for Congenital Heart Surgery (RACHS) category 1,2 and 3 Pediatric patients undergoing corrective congenital cardiac surgeries via a median sternotomy
• Exclusion Criteria:
• • • Refusal of legal guardian.
• • Patient with congestive heart failure .
• • Patient weaned from cardiopulmonary bypass on high doses of inotropic support (Adrenaline or noradrenaline more than 200ng/kg/min).
• • Patient undergoing Redo cardiac surgery.
• • Known allergy to local anesthetics.
• • Infection at injection site.
• • Bleeding disorders (drug induced i.e., coumadin; or genetic i.e. hemophilia; or acquired i.e. DIC), coagulopathy: PTT \> 40 seconds, INR \> 1.4, platelet count \< 100x10⁹.
• • severe renal or hepatic insufficiency.
• • Neurological disorders because it will be difficult to assess their pain score (e.g. cerebral palsy).