Postoperative analgesic effectiveness of bilateral erector spinae plane block for adult cardiac surgery: a randomized controlled trial

Abstract

Introduction: There are few randomized controlled trials examining the effectiveness of bilateral Erector Spinae Plane Block (ESP) with patients undergoing cardiac surgery. The effect of bilateral ESP block on postoperative pain levels and analgesic consumption for patients undergoing open-heart surgery was examined in this single-blind, randomized, controlled trial. Material and Method: 54 patients who underwent cardiac surgery with open median sternotomy under general anesthesia between May 2020 and June 2021 were included in the study. Patients were randomized into two groups, each consisting of 27 patients, one with 40 ml of 0.25% bupivacaine and bilateral ESP block, the other with no block implementation (control group). Demographic data, operation type, length of stay in the Intensive Care Unit (ICU), numerical rating scale (NRS) values in the first 24 hours after extubation, and morphine consumption values of the patients were recorded for the study. Results: In the study, 4 patients were excluded from follow-up due to prolonged intubation in the postoperative period. The data of a total of 50 patients (ESP group n=25; Control group n=25) were analyzed. The duration before first analgesic (mean±SD: 459.2±92.8 min.) of the ESP group was statistically longer than those in the control group (mean±SD: 142.0±56.6 min.) (p<0.001). The total length of stay in the ICU and rate of nausea-vomiting were lower for the ESP group than for the control group (p<0.05). Total morphine consumption (mean±SD: 5.1±3.1 mg) of the ESP group in the first 24 hours was statistically lower (p<0.001) compared to the consumption of the control group (mean±SD: 14.8±4.2 mg). NRS scores were significantly lower for the ESP group at postoperative 1st, 2nd, 4th, 6th, and 8th hours compared to the control group (p<0.05). Conclusion: ESP block applied bilaterally in adult cardiac surgeries decreased postoperative pain scores and morphine consumption. At the same time, it was observed that the length of stay of the patients in the ICU was reduced and there were no complications.

Keywords

• Erector spinae plane block
• Cardiac surgery
• Postoperative pain
• Ultrasound guidance
• Fascial plane block

Supporting Institution

yok

Thanks

We would like to thank the cardiovascular surgery doctors and nurses for their support and patience during the study.

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