Pediatric anesthesia & critical care
Regional analgesia techniques as adjuncts to general anesthesia in pediatric cardiac surgery: an updated systematic review and meta-analysis of randomized controlled trials
Authors' conclusion
There is very low to low certainty of evidence that adjunctive RA is associated with reduced opioid exposure and improved recovery in pediatric cardiac surgery.
Study context
- Population
- Pediatric patients undergoing cardiac surgery
- Participants
- 2,245 patients · 31 randomized controlled trials (RCTs)
- Comparison
- Adjunctive regional analgesia (RA) vs GA with systemic analgesia alone
Methodological detailssubgroup analyses, Searched PubMed, Embase, Cochrane Library and Web of Science up to July 10, 2025
- Subgroup analyses
- Searched PubMed, Embase, Cochrane Library and Web of Science up to July 10, 2025
Pooled result
As reported in the abstract
- Adjunctive RA associated with reduced opioid exposure and improved recovery
- Very low to low certainty of evidence
Further pooled results
| Outcome | MD (µg·kg⁻¹) (95% CI) | |
|---|---|---|
| Intraoperative fentanyl95% PI −9.51 to 4.52; I²=97% | −2.50 (−3.84 to −1.15) | |
| −4−202Difference, µg·kg⁻¹ (linear scale) |
| Outcome | MD (mg·kg⁻¹) (95% CI) | |
|---|---|---|
| 24-hour IV morphine · 95% PI −1.17 to 0.51; I²=96% | −0.33 (−0.55 to −0.11) | |
| −1−0.500.5Difference, mg·kg⁻¹ (linear scale) |
| Outcome | MD (hours) (95% CI) | |
|---|---|---|
| Time to tracheal extubation95% PI −7.78 to 4.34; I²=99% | −1.72 (−2.93 to −0.52) | |
| Time to first analgesia95% PI −1.42 to 7.31; I²=97% | 2.95 (1.86–4.04) | |
| −4−20246Difference, hours (linear scale) |
| Outcome | MD (days) (95% CI) | |
|---|---|---|
| ICU stay95% PI −0.61 to 0.11; I²=93% | −0.25 (−0.34 to −0.16) | |
| −0.4−0.200.2Difference, days (linear scale) |
Subgroup analyses (subgroup)
- Outcome-specific, inconsistent effects
Original publication
Regional analgesia techniques as adjuncts to general anesthesia in pediatric cardiac surgery: an updated systematic review and meta-analysis of randomized controlled trials. Reg Anesth Pain Med. Published 30 March 2026. doi:10.
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