Postoperative pain outcome following a superficial parasternal intercostal plane block in children undergoing pediatric heart surgery: a retrospective cohort study.

Background: Aim of the present study was to investigate the postoperative pain outcome following the implementation of a superficial parasternal intercostal plane (SPIP) block in children undergoing cardiac surgery with a sternotomy.

Methods: We conducted a retrospective cohort study in children undergoing extracardiac Fontan operation or a secundum atrial septal defect closure receiving a SPIP in addition to standard pain treatment versus standard pain treatment only. The primary outcome was the worst pain intensity within 24 hours (median (interquartile range)).

Results: Mean age of the study groups (54 patients each) was 3.22 years (±0.95), respectively 4.26 years (±2.76) in the control group. There was no statistically significant reduction in worst pain intensity 24 hours after surgery in children treated with a SPIP block (3(1-5)) compared to control group (4(2-5)) (p1-tailed = 0.16, d = 0.19). However, 4 and 12 hours after surgery there were significant improvements in median pain intensity in children treated with a SPIP block (p1-tailed = 0.04).

Conclusions: This study showed that implementation of a SPIP block might further improve postoperative pain management following cardiac surgery in children. However, due to lower baseline pain intensity in the control group primary outcome failed significantly. Therefore, further trials are urgently requested.