Effective intraoperative and postoperative pain control in pediatric patients undergoing cardiac surgeries is essential for recovery enhancement and minimizing postoperative complications. A majority of pediatric cardiac surgeries are done through a median sternotomy, which is known to cause severe postoperative pain and increase the risk of chronic pain. In recent literature, regional anesthesia has been effectively utilized by anesthesiologists in various surgical settings to improve postoperative pain and decrease opioid consumption while carrying minimal risks. The purpose of this literature review is to compare the effectiveness of erector spinae plane blocks and single-shot fascial plane blocks to support clinical decision-making and improve patient recovery. Published case reports and current literature on erector spinae plane blocks (ESPB) and fascial plane blocks used in pediatric cardiac surgery via median sternotomy were collected via PubMed, Google Scholar, and the RVUMCOM Frank Ritchel Ames Memorial Library Literature Database and reviewed. Intraoperative and postoperative opioid use, postoperative pain in the first twenty-four hours, and length of ICU stay in patients receiving ESPBs were compared with those of patients receiving fascial plane blocks. ESPBs were found to have significant benefits when compared with single-shot fascial plane blocks. Total opioid consumption, ICU length of stay, and reported post-operative pain were found to be reduced when compared to single-shot fascial plane blocks. ESPBs may present as a potential complementary analgesic route in multimodal pain management in pediatric cardiac patients. Use of ESPBs in additional disciplines requires further study, as this is beyond the scope of this literature review.
