Thoracic Wall Fascial Plane Blocks For Pediatric Cardiac Surgery With Sternotomy

Introduction: In paediatric patients undergoing sternotomy for cardiac surgery, inadequate pain management has been demonstrated to result in cardiopulmonary complications, the development of chronic pain, and prolonged stress responses. Opioids, which are frequently utilised for the purpose of analgesia in these patients, have been observed to induce dose-dependent adverse effects that have the potential to influence postoperative recovery. Methods: The increased utilisation of ultrasound in recent years has led to the integration of regional anaesthesia into multimodal analgesic approaches and its incorporation into Enhanced Recovery After Surgery (ERAS) protocols following cardiac surgery. Fascial plane blocks target intercostal nerves and ventral branches at multiple levels. Moreover, as they do not cause damage to the neuroaxial and paravertebral spaces during the procedure, they are a suitable option for postoperative analgesia in patients requiring full heparinisation for cardiopulmonary bypass. Conclusion: This review synthesises the extant literature on thoracic fascial plane blocks for paediatric patients undergoing cardiac surgery via median sternotomy, with the objective of providing a practical guide for clinicians.