Paravertebral block in pediatric cardiac surgery: a descriptive literature review

This review aimed to describe modern methods of perioperative analgesia in pediatric cardiac surgery, with a particular focus on the application of regional anesthesia for acute pain management and its effects on postoperative recovery. A literature search was conducted from August 15, 2023, to March 1, 2024, using the PubMed (MEDLINE) database and the Cochrane Library. Fifty-one articles were identified and formed the basis of this review. The reviewed literature indicates that regional anesthesia techniques, particularly paravertebral block (PVB), demonstrate high analgesic efficacy in the perioperative period of pediatric cardiac surgery and are associated with fewer complications related to high-dose opioid use. Incorporating PVB into postoperative pain management protocols reduces the risk of emergence agitation, ensures more stable hemodynamics post-extubation in thoracic surgery patients, and improves postoperative pulmonary function indicators. Compared to thoracic epidural analgesia, PVB has lower failure rates and a reduced risk of arterial hypotension, nausea, vomiting, and urinary retention. Evidence from pediatric oncology also supports the efficacy and safety of PVB.