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Review
. 2025 Jan 4;29(1):8.
doi: 10.1007/s11916-024-01357-w.

Efficacy of Transversus Thoracic Plane Block for Pain Management in Cardiac Surgeries

Alan D Kaye  1 , Carliss M Sampognaro  2 , Shivam S Shah  2 , Drake P Duplechin  2 , Grant C Curry  2 , Victoria A Rodriguez  2 , Shahab Ahmadzadeh  3 , Jibin Mathew  3 , Zachary R Palowsky  3 , Sahar Shekoohi  4
Affiliations
Review

Efficacy of Transversus Thoracic Plane Block for Pain Management in Cardiac Surgeries

Alan D Kaye et al. Curr Pain Headache Rep. .

Abstract

Purpose of review: Effective pain management in cardiac surgery presents as a continuous challenge related to the intensity of postoperative pain and reliance on opioid therapy. The dependance of opioid-based therapies is concerning, as these therapies carry risk future addiction and potential severe side effects. The transversus thoracic plane block (TTPB) has emerged as a promising regional anesthesia technique that blocks the anterior branches of the intercostal nerves in the chest wall, potentially providing improved analgesia for cardiac surgery patients. The present investigation evaluates the efficacy of TTPB in reducing opioid consumption, decreasing postoperative pain scores, and enhancing recovery outcomes in patients undergoing cardiac surgeries.

Recent findings: Data from randomized controlled trials revealed that TTPB significantly reduced 24-hour opioid consumption, increased the time to first rescue analgesic, and lowered Visual Analog Scale (VAS) pain scores both at rest and with movement, particularly in the first 12 h post-surgery. Additional benefits include fewer opioid-related side effects, such as nausea and pruritus, and reductions in intensive care unit (ICU) length of stay. Studies also suggested that TTPB can support earlier extubation and accelerated recovery, contributing to higher patient satisfaction and overall improved postoperative outcomes.

Conclusion: Despite these promising results, challenges in technique standardization and limited long-term data are still obstacles that prevent widespread adoption. Achieving consistent TTPB efficacy requires technical precision in ultrasound guidance, and there is little research on its effectiveness across diverse populations, such as pediatric and high-risk cardiac patients. Addressing these gaps through multi-center, long-term studies could help establish TTPB as a prominent pain management strategy in cardiac surgery to minimize opioid dependence and enhance patient comfort and recovery.

Keywords: Analgesia; Cardiac surgery; Opioid consumption; Postoperative pain management; TTPB; Transversus thoracic plane block.

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Conflict of interest statement

Declarations. Ethical Approval: This article is based on previous studies and contains no new studies with human participants or animals performed by any authors. Competing Interests: ADK is the section editor for CPHRs.

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