Postoperative pain management is an essential component of perioperative care in pediatric congenital cardiac surgery. Regional anesthesia techniques, including the erector spinae plane block (ESPB) and modified pectoral fascial plane block (M-PFPB), are increasingly used as part of multimodal analgesia; however, evidence directly comparing these techniques in pediatric cardiac surgery remains limited. This prospective randomized controlled study aims to compare the analgesic efficacy of ESPB and M-PFPB in pediatric patients undergoing elective congenital cardiac surgery. The primary objective is to identify the regional anesthesia technique associated with more effective postoperative pain control. Secondary objectives include comparison of perioperative opioid consumption, hemodynamic parameters, extubation time, postoperative pain scores, perioperative complications, and intensive care unit and hospital length of stay. The findings are expected to contribute to the optimization of perioperative analgesia protocols and improve postoperative recovery in pediatric cardiac surgery.
Inclusion Criteria: * Patients younger than 18 years of age. * Scheduled for first-time elective congenital cardiac surgery. * Written informed consent obtained from a parent or legal guardian. Exclusion Criteria: * Redo cardiac surgery. * Emergency surgery. * Contraindication to regional fascial plane block (e.g., infection at the injection site or allergy to local anesthetics). * Coagulopathy. * Chronic liver disease. * Renal failure. * History of opioid use before surgery. * Failure to obtain written informed consent from a parent or legal guardian.