Regional Anesthesia and Acute Pain ManagementRegional Anesthesia and Acute Pain ManagementРегионарная анестезия и лечение острой боли1993-65082687-1394Eco-Vector63654710.17816/RA636547ReviewsНаучные обзорыReview ArticleParavertebral block in pediatric cardiac surgery: a descriptive literature reviewПрименение паравертебральной блокады в детской кардиохирургии: описательный обзор литературыhttps://orcid.org/0000-0003-3971-21048831-4205TarasovEvgenii M.ТарасовЕвгений Михайлович
Russian Federation

MD, anesthesiologist-resuscitator

врач анестезиолог-реаниматолог

tarasov.em15@gmail.comhttps://orcid.org/0000-0002-3162-62988640-9591KhinovkerVladimir V.ХиновкерВладимир Владимирович
Russian Federation

MD, Dr. Sci. (Medicine)

д-р мед. наук, доцент

vhinov@hotmail.comhttps://orcid.org/0000-0002-9363-56163297-6864SvalovAlexey I.СваловАлексей Игоревич
Russian Federation

MD, Cand. Sci. (Medicine)

канд. мед. наук

alsva78@gmail.comhttps://orcid.org/0000-0002-3400-89896101-0578KoriachkinVictor A.КорячкинВиктор Анатольевич
Russian Federation

MD, Dr. Sci. (Medicine), Professor

д-р мед. наук, профессор

vakoryachkin@mail.ruhttps://orcid.org/0000-0002-1860-46096912-7740FedorovDmitrii A.ФёдоровДмитрий Андреевич
Russian Federation

anesthesiologist-resuscitator

врач анестезиолог-реаниматолог

293333666fedorov@gmail.comSverdlovsk Regional Hospital № 1Свердловская областная клиническая больница № 1Federal Siberian Scientific and Clinical CenterФедеральный сибирский научно-клинический центрVoyno-Yasenetsky Krasnoyarsk State Medical UniversityКрасноярский государственный медицинский университет им. проф. В.Ф. Войно-ЯсенецкогоSverdlovsk Regional Hospital № 1Свердловская областная клиническая больница № 1St. Petersburg State Pediatric Medical UniversityСанкт-Петербургский государственный педиатрический медицинский университет11012025251220241843123222809202420112024Copyright ©; 2024, Eco-VectorCopyright ©; 2024, Эко-Вектор2024Eco-VectorЭко-Векторhttps://rjraap.com/1993-6508/article/view/636547

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.

Целью обзора стало описание современных методов аналгезии в периоперационном периоде в детской кардиохирургии, примеров применения регионарной анестезии для контроля острого болевого синдрома и ее влияния на течение послеоперационного периода. Поиск публикаций проводили за период с 15.08.2023 по 01.03.2024 в базе данных PubMed (MEDLINE) и электронной библиотеке Cochrane Library. В процессе исследования была найдена 51 статья, которые составили основу обзора. Согласно данным литературы, применение регионарных методов анестезии и, в частности, паравертебральной блокады (ПВБ) в детской кардиохирургии имеет высокую анальгетическую эффективность в периоперационном периоде и ассоциировано с меньшим числом осложнений, связанных с использованием опиоидов в высоких дозировках. ПВБ в протоколе послеоперационного обезболивания снижает риск ажитации при пробуждении, сопровождается более стабильной гемодинамикой после экстубации у пациентов в торакальной хирургии, ассоциируется с лучшими послеоперационными показателями функции внешнего дыхания. Использование ПВБ сопровождается меньшим числом неудач по сравнению с торакальной эпидуральной аналгезией, а также меньшим риском развития артериальной гипотензии, тошноты и рвоты, задержки мочи. Применение ПВБ в детской онкологии подтверждает эффективность и безопасность метода.

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