Why the study?
Severe sternotomy discomfort requires multimodal analgesia, and the erector spinae plane block has recently become popular in cardiac anaesthesia, warranting evaluation of its opioid-sparing efficacy.
Does ultrasound-guided continuous bilateral erector spinae plane block improve pain scores and reduce opioid consumption compared to intravenous morphine in patients undergoing cardiac surgery requiring median sternotomy?
Does ultrasound-guided continuous bilateral erector spinae plane block improve pain scores and reduce opioid consumption compared to intravenous morphine in patients undergoing cardiac surgery requiring median sternotomy?
Ultrasound-guided continuous bilateral erector spinae plane block significantly improves postoperative analgesia and reduces intravenous opioid consumption compared to intermittent intravenous morphine in patients undergoing cardiac surgery via median sternotomy.
Answers are grounded in this paper and cite their sources.
ESP block may reduce opioid needs after sternotomy; leaves open its role pending randomized trials.
The erector spinae plane (ESP) block is mostly used to relieve pain in people who have had breast surgery. The block is now being used in cardiac surgery. Because sternotomy discomfort is severe, individuals undergoing this require multimodal analgesia. The ESP block has recently become popular in cardiac anaesthesia, necessitating the study. To determine the efficacy of ESP block in reducing the opioid requirement for postoperative analgesia in cardiac surgeriesThe study enrolled 66 people who were having heart surgery between January-2020 to December-2021; that required a median sternotomy. The anaesthesiologist separated them into two groups: group-1 received intravenous morphine, while group-2 received ESP block. The subjects were secured with a catheter in the ESP using USG guidance after receiving general anaesthesia according to institutional practice. Following Surgery, group-2 received 0.25% levobupivacaine bolus of 10ml, followed by a 0.125% levobupivacaine infusion at a rate of 5ml/hour. The other group was given 0.1mg/kg body weight of morphine every six hours. Following extubation, the subjects were assessed for pain using the Prince Henry hospital pain scale at intervals of 0, 3, 6, 12, 24, 48 hours 12 participants in the group-2 had the pain score of 1/5, at 6th hour interval whereas only 5 participants in the group-1 had 1/5. Further at 48-hour interval 30 of the participants in study group had pain score of 0/5, and only 19 participants in the control group had the pain score of zero. ESP block group had more patients with a pain score of zero than morphine group at different time points i.e., 5 vs 0 at 6 h; 30 vs 19 at 48 h (P<0.05). ESP block has significantly reduced the intravenous opioid consumption, and it has also proved to have better patient satisfaction
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Kamath et al. (2025) studied this question.
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