Use of local anesthetic (0.25% bupivacaine) for pain control after pediatric cardiac catheterization: A randomized controlled trial

Abstract

Objectives: To investigate the effects of local infiltration of 0.25% bupivacaine on postoperative pain and analgesic use in children undergoing cardiac catheterization procedures. Background: In pediatric catheterization procedures performed under general anesthesia, a local anesthetic is often used prior to femoral sheath removal. There are no published reports of the impact of local anesthetic infiltration on pain after pediatric procedures, and mixed reports on its effectiveness in adults. Methods: A randomized controlled trial was undertaken of 140 children, aged 7-18 years undergoing cardiac catheterization under general anesthesia via the femoral vein or artery. Participants received a subcutaneous infiltration of 0.25% bupivacaine at the access site prior to sheath removal, or usual care without bupivacaine. Outcomes included patient reported pain scores and analgesic use up to 6 hr after the procedure. Results: Pain scores were similar between groups through the 6-hr post-procedure period. The proportion of children reporting a maximal pain score of 2/10 was higher in the bupivacaine group (64% vs. 44%, P 5 0.03). A significantly higher proportion of children in the control group required IV morphine (18.8% vs. 4.5%, P 5 0.02). Conclusions: Morphine use can be reduced with the use of 0.25% bupivacaine given prior to femoral sheath removal and should be considered for post-procedural pain control for pediatric patients undergoing cardiac catheterization. This study is the first to contribute evidence to the effectiveness of 0.25% bupivacaine after pediatric cardiac catheterization. V C 2015 Wiley Periodicals, Inc.

An in vivo study comparing efficacy of 0.25% and 0.5% bupivacaine in infraorbital nerve block for postoperative analgesia

“…Palma et al [20] advocated the use of 0.25% bupivacaine for pain control in pediatric patients undergoing cardiac catherization. Souza et al [21] reported that femoral nerve block using 0.25% bupivacaine or 0.25% ropivacaine was efficacious in postoperative analgesia after total knee replacement or anterior cruciate ligament reconstruction.…”