Analgesic Efficacy of Bilateral US Guided TTPB vs ESPB in Pediatric Patients Undergoing Corrective Cardiac Surgeries

Corrective cardiac surgeries include a bundle of major surgeries that take place in pediatric patients and require imperative perioperative pain control; hence, the art of healing starts from trying to diminish or abolish pain. The use of highly potent opioids for paediatric cardiac anaesthesia has gained widespread popularity during the last 20 years . In addition to the important advantage of hemodynamic stability, the large-dose opioid-based anaesthetic techniques also blunt the stress response; however, large doses can cause over sedation, respiratory depression and prolonged mechanical ventilation after surgery . There are many ways to limit pain in such population with the topper potent opioids in the last several years. But new regional pain management modalities started to arise because of their known effect to diminish neuroendocrine stress response, provide excellent postoperative analgesia, and facilitate early postoperative extubation . Of the new evolving methods, the bilateral Transversus Thoracic Muscle Plane Block (TTPB) provides analgesia to the anterior chest wall and proved to be efficient in pediatric patients undergoing cardiac surgery using a median sternotomy approach . The bilateral Erector Spinae Plane Block (ESPB) is also one of the recently known pain controlling techniques used in pediatric cardiac surgeries. It became popular because it is much safer and easily administered than other alternative regional techniques as thoracic paravertebral and thoracic epidural block .