LAUSR

Background Thoracic retrolaminar block (TRLB) is a relatively new regional analgesic technique that can be used as an alternative to thoracic paravertebral block. This study aimed to evaluate the postoperative analgesic effects of ultrasound-guided TRLB in children undergoing open cardiac surgery via median sternotomy incision. Methods Sixty-six patients aged 2 to 8 years undergoing cardiac open cardiac surgery via median sternotomy incision were recruited. In the TRLB group, 0.25% bupivacaine 0.4mL/kg was injected into the retrolaminar space on each side at the level of T4 lamina. Patients in the control group were injected with 0.9% saline. The primary outcome measure was the 24h post-extubation fentanyl consumption. The secondary outcome measures were total intraoperative fentanyl consumption, postoperative modified objective pain score (MOPS) and time to extubation. Results The mean±SD total intraoperative fentanyl requirements (μg/kg) and the 24h post-extubation fentanyl consumption (μg/kg) were significantly lower (P<0.001) in the TRLB group (9.3±1.2&6.9±2.1 respectively) than the control group (12.5±1.4&16.6±2.8 respectively). The median (Q1, Q3) time (h) of extubation and the mean±SD time (h) of ICU length of stay were significantly shorter (P<0.001) in the TRLB group (2 [1-3] &23.8±3.2 respectively) in comparison with the control group (6 [4.5-6] & 30.3±3.2 respectively). MOPS was significantly lower (P<0.05) in the TRLB group than the control group at the following time points, 0, 2, 4, 8, 12 and16 hours after extubation. Conclusions Bilateral ultrasound-guided TRLB is effective in providing postoperative analgesia in children undergoing open cardiac surgery via median sternotomy incision.