Remifentanil-based fast-track cardiac anesthesia combined with the postoperative serratus anterior plane block for transthoracic device closure of atrial septal defect in pediatric patients

J Card Surg. 2021 Jul;36(7):2263-2268. doi: 10.1111/jocs.15527. Epub 2021 Apr 3.

Abstract

Background: To evaluate the safety and effectiveness of remifentanil-based fast-track cardiac anesthesia (FTCA) combined with the postoperative serratus anterior plane block (SAPB) for transthoracic device closure of atrial septal defect (ASD) in pediatric patients.

Methods: A total of 70 children who underwent transthoracic device closure of ASDs from January 2018 to June 2020 were divided into two groups according to different anesthesia strategies administered, namely group F (fast-track anesthesia, n = 38) and group R (routine anesthesia, n = 32), and relevant clinical data were collected and analyzed.

Results: There was no statistically significant difference between the two groups in general preoperative data, intraoperative hemodynamics, and FLACC score 1 h after extubation (p > .05). FLACC score of Group F was significantly lower than that of group R at 4, 8, 12, and 24 h after extubation (p < .05). The number of postoperative PCA press and the dose of PCA infusion in group F were lower than those in group R (p < .05). The mechanical ventilation duration, the length of intensive care unit stay in group F were statistically significantly lower than those in group R (p < .05).

Conclusion: Remifentanil-based FTCA combined with the postoperative SAPB for transthoracic device closure of ASD in pediatric patients could effectively reduce postoperative pain of the children.

Keywords: CHD; cardiac intervention; fast-track cardiac anesthesia.

MeSH terms

  • Anesthesia, Cardiac Procedures*
  • Child
  • Heart Septal Defects, Atrial* / surgery
  • Humans
  • Nerve Block*
  • Pain, Postoperative / drug therapy
  • Pain, Postoperative / prevention & control
  • Remifentanil
  • Treatment Outcome

Substances

  • Remifentanil