Pediatric anesthesia & critical care
Combined Pecto-intercostal Fascial Plane and Rectus Sheath Blocks Versus Local Infiltration for Pain Management Following Pediatric Cardiac Surgery: A Randomized Clinical Trial
Primary result · Opioid use (MME/kg)Result — go to the resultMean difference −0.39 MME/kg 95% CI −0.59 to −0.18Authors' conclusion
This single-center study showed that the combined pecto-intercostal fascial plane and rectus sheath blocks were opioid-sparing and provided superior pain control compared to contemporary practice of local anesthetic infiltration in children following septal defect repair.
Study context
- Population
- Children (<18 years) undergoing primary atrial septal defect (ASD) or ventricular septal defect (VSD) repairincluded in analysis
- Participants
- 42 children
- Comparison
- Regional anesthesia (RA) vs Infiltration
- RAn = 24
- Infiltrationn = 18reference
- Primary endpoint
- Opioid use (oral MME/kg)
- Follow-up
- 0-12 hours after surgery
Methodological detailsdouble-blind, parallel group, single-center, active comparator
- Double-blind
- Parallel group
- Single-center
- Active comparator
Primary result
Opioid use (MME/kg)
Mean difference
−0.39 MME/kg
95% CI −0.59 to −0.18
P = 0.001
By group
RA vs Infiltration
mean difference −0.39 MME/kg (95% CI −0.59 to −0.18); P = 0.001
As reported in the abstract
Secondary outcomes
Mean, MME/kg
| Outcome | RA | Infiltration | Mean difference (MME/kg) (95% CI) | P value | |
|---|---|---|---|---|---|
| Total postoperative opioid use (MME/kg) · 0 to 48 hours after surgery | 0.95 (SD 0.40) | 1.57 (SD 0.75) | −0.64 (−1.02 to −0.22) | P = 0.004 | |
| −1.5−1−0.500.5Difference, MME/kg (linear scale) |
Mean
| Outcome | RA | Infiltration | Mean difference (CI) | P value | |
|---|---|---|---|---|---|
| Pain intensity AUC (0-10 scale) · 0-48 hours | 45.0 (SD 26.8) | 94.5 (SD 55.7) | −49.5 (−78.9 to −20.1) | P = 0.002 | |
| −100−50050Difference (linear scale) |
Opioid use 12-48 hours and hospital length of stay (LOS)
- Not different between groups
Original publication
Combined Pecto-intercostal Fascial Plane and Rectus Sheath Blocks Versus Local Infiltration for Pain Management Following Pediatric Cardiac Surgery: A Randomized Clinical Trial. Anesth Analg. Published 1 October 2025. doi:10.
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