Ultrasound-guided Procedures for Postoperative Pain Management in Paediatric Patients Undergoing Thoracic Surgeries: A Systematic Review.

BACKGROUND: This systematic review seeks to assess and compare various ultrasound-guided procedures for delivering analgesia through peripheral nerve blockade, aiming to ascertain the most effective approach for paediatric thoracic surgeries. The primary goal is to evaluate the efficiency of these ultrasound_guided procedures in managing postoperative pain among children undergoing thoracic surgeries. MATERIALS AND METHODS: A systematic literature search was performed in PubMed, SCOPUS, Central Cochrane Registry of Controlled Trials (The Cochrane Library) and Science Direct databases for paediatric thoracic surgeries conducted with ultrasound-guided procedures for administering analgesia. We included studies involving randomised controlled trials (RCTs) only. Quasi-randomised controlled studies, prospective, retrospective observational studies, case series, case reports, letters, editorials, comments, animal studies and studies from non-English literature were excluded. RESULTS: After screening 29 articles with our search strategy and removing duplicates, a total of 4 articles met our criteria. Analysing 225 patients from RCTs, TTPB (29.78%) was the most used block. Opioid consumption varied, but overall trends aligned with pain scores. Time to the first analgesia ranged from 5 to 7 h, with PIPB at 5 h. Complications included pneumothorax and hematoma with TTPB and hematoma with PIPB (n = 3). CONCLUSIONS: While the existing body of literature is limited, this study underscores the crucial need for additional RCTs to thoroughly investigate the optimal procedures for various types of thoracic surgeries. The scarcity of studies emphasises the importance of further research to glean meaningful conclusions and enhance our understanding of the most suitable approaches in this field.