The use of paravertebral block in aortic valve and aortic root surgery in adolescents: a case series

Introduction: Adequate pain control during the intra- and postoperative periods is a crucial aspect of pediatric cardiac surgery. The use of paravertebral block as a regional anesthesia method is of interest due to the limited number of approved analgesics for children and the need to reduce risks associated with the opioid use. Objective: To evaluate the effectiveness and safety of paravertebral block in adolescents undergoing aortic valve and aortic root surgery. Methods: A retrospective analysis of data from five patients aged 14–17 years who underwent aortic valve and aortic root surgery was conducted. All patients received paravertebral block under ultrasound guidance with the administration of ropivacaine. Intra- and postoperative parameters were assessed, including pain intensity, opioid requirements, extubation time, and complications. Results: Adequate pain control was achieved in all patients with minimal opioid requirements. Four patients were extubated on the operating table, and one patient was extubated 10 minutes after transfer to the ICU. Postoperative pain was rated as moderate or low. No complications related to PVB were reported. Conclusion: Adequate pain control was achieved in all patients with minimal opioid requirements. The intraoperative fentanyl requirement was 1.67 [1.5;2.1] mcg/kg/hr. Four patients (80%) were extubated on the operating table, and one was extubated 10 minutes after being transferred to the intensive care unit. Postoperative pain was assessed as moderate or mild. The postoperative fentanyl dose was 0.83 [0.83;0.99] mcg/kg/hr. No complications related to the paravertebral block were observed.