The Effect of Continuous Field Block through Intercostal Muscles after Atrial Septal Defect Closure via a Mini-Right Thoracotomy in Pediatric Patients

• Suzuki Kenji

  Department of Cardiovascular Surgery, Nippon Medical School

• Sasaki Takashi

  Department of Cardiovascular Surgery, Nippon Medical School

• Miyagi Yasuo

  Department of Cardiovascular Surgery, Nippon Medical School

• Mori Keisuke

  Department of Anesthesiology, Nippon Medical School

• Kishikawa Hiroaki

  Department of Anesthesiology, Nippon Medical School

• Ishii Yosuke

  Department of Cardiovascular Surgery, Nippon Medical School

• Sakamoto Atsuhiro

  Department of Anesthesiology, Nippon Medical School

• Nitta Takashi

  Department of Cardiovascular Surgery, Nippon Medical School

抄録

Background: Postoperative pain management in thoracotomy patients often is difficult. Furthermore, pediatric patients present more challenges because of their inability to effectively communicate their pain intensity. The purpose of this study was to evaluate the use of continuous field block through intercostal muscles as postoperative pain management in pediatric thoracotomy. Methods: Between 2014 and 2018, 11 patients underwent an ASD closure using a cardiopulmonary bypass via a mini-right thoracotomy through the fourth intercostal space. At the time of chest closure, a single-shot field block via the fourth intercostal muscles was performed with levobupivacaine (0.6 mg/kg). The first five patients were only given the single-shot field block (Single group). The remaining six patients were given levobupivacaine continuously (0.1 mg/kg/hr) through an indwelling catheter until the chest tube removal (Continuous group). The groups' vital signs, total amounts of acetaminophen used, postoperative courses were compared. Results: Although the heart rate did not differ between the groups, the respiratory rate was significantly higher in the Single group versus the Continuous group at 16 and 32 hr post-surgery (35.6 ± 9.7/min vs. 18.5 ± 4.7/min; p=0.007, 43.0 ± 10.4 vs. 25.3 ± 3.1; p=0.042, respectively). The accumulated dosage of acetaminophen given by postoperative day 2 was significantly higher in the Single group versus the Continuous group (55.3 ± 22.1 mg/kg vs. 7.8 ± 17.4 mg/kg; p=0.012). Conclusions: Continuous field block via intercostal muscles after ASD closure via a mini-right thoracotomy in children was effective to stabilize the vital signs and reduce the analgesic medication use.

収録刊行物

• 日医大誌

  日医大誌 88 (4), 347-353, 2021-08-25

  日本医科大学医学会

キーワード

• congenital heart defects
• local anesthesia
• thoracotomy
• minimally invasive surgical procedures

詳細情報

• CRID: 1390289232189836800
• NII論文ID: 130008082560
• NII書誌ID: AA11563215
• DOI: 10.1272/jnms.jnms.2021_88-507
• ISSN: 13473409
• ISSN: 13454676
• PubMed: 33250477
• Web Site: https://nms.repo.nii.ac.jp/records/557
• Web Site: https://www.jstage.jst.go.jp/article/jnms/88/4/88_JNMS.2021_88-507/_pdf
• Web Site: https://search.jamas.or.jp/link/ui/2022238020
• 本文言語コード: en
• データソース種別:
  • JaLC
  • IRDB
  • Crossref
  • PubMed
  • CiNii Articles
  • KAKEN
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