Comparison of Parasternal Intercostal Block Using Ropivacaine or bupivacaine for Postoperative Analgesia in Patients Undergoing Cardiac Surgery

Kulbhushan Saini^1*, Sandeep Chauhan¹, Usha Kiran¹, Akshay Kumar Bisoi², Minati Choudhury¹, Suruchi Hasija¹

¹Department of Cardiothoracic and Vascular Anaesthesia, CN Centre, All India Institute of Medical Science, New Delhi, India.
²M.CH Cardiothoracic and Vascular Surgery, All India Institute of Medical Science, New Delhi, India.

DOI: 10.4236/wjcs.2015.56009                

Abstract

Objective: The objective of this study was to compare the efficacy of 0.5% ropivacaine and 0.25% bupivacaine for parasternal intercostal block for postoperative analgesia in children undergoing cardiac surgery. Design: A randomized, controlled, prospective, double blind study. Setting: A tertiary care teaching hospital. Participants: One Hundred children scheduled for cardiac surgery through a median sternotomy were divided into 3 groups of at least 33 children each, receiving either ropivacaine, bupivacaine or saline (control). Interventions: A bilateral parasternal block performed either with 0.5% ropivacaine or 0.25% bupiacaine or 0.9% saline with 5 doses of 0.5 mL on each side in the 2nd to 6th parasternal intercostal spaces 1 to 1.5 cm lateral to the sternal edge, before sternal wound closure. Measurements and Main Results: The time to extubation was significantly less in children administered the parasternal blocks with ropivacaine or bupivacaine compared to the saline (control) group. The pain scores were lower and comparable in the ropivacaine and bupivacaine groups compared to the saline group. The cumulative fentanyl dose requirement over a 24-hour period was higher in the saline group than the ropivacaine (p < 0.001) and bupivacaine group. No side effects were observed in any of the children. Conclusions: Parasternal blocks either with ropivacaine or bupivacaine appear to be a simple, safe, and useful technique for supplementation of postoperative analgesia in children undergoing cardiac surgery with a median sternotomy.

Keywords

Pediatric Cardiac Patients, Parasternal Intercostalblock, Sternotomy, Ropivacaine, Bupivacaine, Postoperative Pain

Conflicts of Interest

The authors declare no conflicts of interest.

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