Why the study?
While erector spinae plane block is used for multimodal analgesia in cardiac surgery, its effect on the neutrophil-lymphocyte ratio remained to be comparatively evaluated.
Does ultrasound-guided bilateral erector spinae plane block reduce the neutrophil-lymphocyte ratio and improve postoperative analgesia in patients undergoing on-pump coronary artery bypass graft surgery?
Does ultrasound-guided bilateral erector spinae plane block reduce the neutrophil-lymphocyte ratio and improve postoperative analgesia in patients undergoing on-pump coronary artery bypass graft surgery?
Preoperative bilateral erector spinae plane block in cardiac surgery not only reduces postoperative opioid consumption but also significantly attenuates the systemic inflammatory response as measured by the neutrophil-lymphocyte ratio.
ESP block may lower NLR after CABG; hypothesis-generating and requires prospective trials before practice change.
Objectives:In cardiac surgery, a successful erector spinae plane (ESP) block has been demonstrated within the scope of multimodal analgesic approach.This study aimed to comparatively evaluate the effect of ESP block used in cardiac surgery on neutrophil-lymphocyte ratio (NLR).Methods: Patients who underwent an ESP block and conventional analgesia technique for coronary artery bypass grafting surgery were retrospectively compared.Postoperative pain scores, analgesic consumption, extubation times, and intensive care unit (ICU) and hospital stays were recorded with patient and operative data.As the study's primary outcome, NLR values were calculated from the hemogram as an indicator of inflammation during the preoperative period and 3 days postoperatively.Results: A total of 97 patients who underwent coronary artery bypass graft surgery with cardiopulmonary bypass were investigated.The highest pain score (p=0.016),total opioid (p=0.008) and acetaminophen (p=0.009)consumption, extubation (p=0.024), and ICU stay (p=0.045) in the first 24 h after extubation were significantly lower in the ESP group.NLR (p=0.019,p=0.046, and p=0.038, respectively) was significantly lower in the ESP group in the first 3 days. Conclusion:In addition to being associated with less opioid use in the first 24 h in the postoperative pain management of cardiac surgery, ESP block reduces NLR 3 days postoperatively.
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Aslıhan Aykut (2023) studied this question.
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