• Meltem Cakmak and Onur Isik.
• Department of Anesthesiology, Tepecik Training and Research Hospital, Izmir, Turkey. Electronic address: meltemdenn@yahoo.com.
• J. Cardiothorac. Vasc. Anesth. 2021 Jan 1; 35 (1): 130-136.

ObjectiveThe objective of this study was to assess the effectiveness of transversus thoracic muscle plane block (TTPB) as a novel technique for postoperative analgesia in pediatric cardiac surgery.DesignA retrospective study.SettingA tertiary care teaching hospital.ParticipantsChildren who underwent congenital heart surgery through median sternotomy between January 2018 and March 2019.InterventionsBilateral ultrasound-guided TTPB was performed as a single-shot technique before the sternal incision. A total dose of bupivacaine 0.25% (0.5 ml/kg) was injected between the fourth and fifth ribs just lateral to the sternum. Patients who received TTPB were designated as the TTPB group, and the other group was named the non-TTPB group MEASUREMENTS AND MAIN RESULTS: Thirty-three patients underwent intraoperative bilateral TTPB before the sternal incision and 37 did not. The groups were comparable as for demographic and intraoperative clinical characteristics. Pain scores were significantly lower in the TTPB group compared with the non-TTPB group (p < 0.001). Intraoperatively, non-TTPB patients received significantly higher doses of fentanyl (p < 0.001). Moreover, the total fentanyl dose during a 24-hour period was also higher in the non-TTPB group (p < 0.001). The time to extubation was significantly lower in the TTPB group than in the non-TTPB group (p < 0.001).ConclusionsTTPB appeared to be an effective technique for postoperative analgesia in pediatric patients undergoing cardiac surgery using a median sternotomy approach.Copyright © 2020 Elsevier Inc. All rights reserved.

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