Background: Complications associated with suboptimal pain management after pediatric cardiac surgery have increased interest in regional anesthesia (RA). We sought to evaluate national trends and explore the association of RA with postoperative outcomes following pediatric cardiac surgery.
Methods: Patients <18 years in the Society of Thoracic Surgeons Congenital Cardiac Anesthesia Society Database from 01/2016-05/2023 were analyzed. Non-OR operations and records with missing data on RA were excluded. Data on patients, centers, operations, year, and RA type and medication were collected, and trends over the 8-year study period were analyzed. The association of RA with outcomes was analyzed with multivariable modeling in a subpopulation of children without preoperative risk factors who underwent index atrial and ventricular septal defect (ASD/VSD) repairs and Fontan procedures.
Results: The cohort included 95,514 operations from 62 U.S.
Centers: RA was used in 8.4 % (N = 7997) and increased annually from 6.1 % in 2016 to 12.5 % in 2023. Prevalence was highest in cases performed in children 1-11 years, characterized as low risk, and conducted low volume centers. There were statistically significant increases (p < 0.001) in RA use across all age groups and surgical risk categories during the study period. While the number of neuraxial techniques remained constant year-to-year, the number of non-neuraxial techniques (i.e., fascial plane blocks) increased sixfold during the study period. In the sub-analysis cohort (N = 7931), patients with RA for septal defect repairs and Fontan procedures were more likely to be extubated in the OR compared to non-RA patients (p < 0.001). ASD and VSD patients with RA were also more likely to have a short length of stay compared to those without RA (p < 0.001).
Conclusions: RA use is increasing in pediatric cardiac surgery in the U.S. and may be associated with surgery-specific outcome improvements.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11875892 | PMC |
| http://dx.doi.org/10.1016/j.jclinane.2025.111774 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
A New Method Using the Four-Chamber View to Identify Fetuses With Subsequently Confirmed Postnatal Aortic Coarctation.
Echocardiography
March 2025
Division of Pediatric Cardiology, Department of Pediatrics, UCLA Mattel Children's Hospital, David Geffen School of Medicine at UCLA, Los Angeles, California, USA.
Objective: To determine the sensitivity, specificity, and false-positive rate among fetuses suspected prenatally to have coarctation of the aorta (CoA) using size and shape measurements of the fetal heart from the four-chamber view (4CV).
Methods: This was a retrospective study of 108 fetuses identified by pediatric cardiologists to be at risk for CoA. 4CV s from the last antenatal ultrasound performed by the cardiologists were analyzed.
Frequency of Culture-proven Bacterial Infection and Radiographic Pneumonia in Pediatric Heart Transplant Recipients.
Pediatr Infect Dis J
March 2025
Divisions of Pediatric Emergency Medicine and Pediatric Infectious Diseases, Baylor College of Medicine, Houston, Texas.
Background: Infection is a leading cause of death after pediatric heart transplants (PHTs). Understanding of common pathogens is needed to guide testing strategies and empiric antibiotic use.
Methods: We conducted a 3-center retrospective study of PHT recipients ≤18 years old presenting to cardiology clinics or emergency departments (EDs) from 2010 to 2018 for evaluation of suspected infections within 2 years of transplant.
Association of family history of cardiovascular disease with the prevalence of cardiometabolic risk factors in young adults in the United Arab Emirates: The UAE healthy future study.
PLoS One
March 2025
Public Health Research Center, New York University Abu Dhabi, Abu Dhabi, United Arab Emirates.
Introduction: Family history of cardiovascular disease (CVD) is an independent risk factor for coronary heart disease, and the risk increases with number of family members affected. It offers insights into shared genetic, environmental and lifestyle factors that influence heart disease risk. In this study, we aimed to estimate the association of family history of CVD and its risk factors, as well as the number of affected parents or siblings, with the prevalence of major cardiometabolic risk factors (CRFs) such as hypertension, dysglycemia, dyslipidemia and obesity in a sample of young adults.
View Article and Find Full Text PDFEvaluation of multiple ventricular septal defects using three-dimensional reconstruction models.
Eur J Cardiothorac Surg
March 2025
Department of Pediatrics, University of Toyama, Graduate School of Medicine, Toyama, Japan.
Objectives: Although there has been rapid development in the field of three-dimensional morphological analyses of congenital heart disease, with the three-dimensional volume-rendered images providing visualization of the external vascular anatomy, the precise reproduction of "Swiss-cheese" ventricular septum is not well established. We created three-dimensional printed models and computer graphics based on multi-slice computed tomography of patients with complex multiple ventricular septal defects for surgical decision planning of this difficult cardiac defect.
Methods: Seven patients with complex multiple ventricular septal defects were evaluated preoperatively using three-dimensional printed models and computer graphics to plan therapeutic interventions.
Left ventricular-arterial coupling and mortality in the cardiac intensive care unit.
Eur Heart J Acute Cardiovasc Care
March 2025
Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA.
Background: Left ventricular (LV) ventricular-arterial coupling (VAC) refers to the ratio of afterload (effective arterial elastance) to contractility (end-systolic elastance) as an integrated marker of cardiac performance. We sought to determine whether the echocardiographic VAC ratio, defined using the ratio of LV end-systolic volume (LVESV) to stroke volume (SV), predicted mortality in the cardiac intensive care unit (CICU).
Methods: Mayo Clinic CICU patients from 2007 and 2018 were included.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!