Key result
Continuous bilateral erector spinae plane blocks prior to open cardiac surgery reduced opioid consumption during hospitalization compared to historical controls (224 vs. 461 mg).
Why the study?
To test the hypothesis that preoperative continuous bilateral erector spinae plane blocks would reduce opioid consumption and improve outcomes compared with standard practice in open cardiac surgery patients.
Does ultrasound-guided continuous bilateral erector spinae plane block reduce opioid consumption in patients undergoing open cardiac surgery?
Cohort (n=78)
Does ultrasound-guided continuous bilateral erector spinae plane block reduce opioid consumption in patients undergoing open cardiac surgery?
Absolute Event Rate: 224% vs 461%
Continuous bilateral erector spinae plane blocks significantly reduce perioperative opioid requirements and shorten hospital length of stay in patients undergoing open cardiac surgery.
May support opioid-sparing ESP blocks in open cardiac surgery; leaves open need for randomized trials before practice change.
This study tested the hypothesis that continuous bilateral erector spinae plane blocks placed preoperatively would reduce opioid consumption and improve outcomes compared with standard practice in open cardiac surgery patients. Patients who received bilateral continuous erector spinae plane blocks for primary open coronary bypass, aortic valve, or ascending aortic surgery were compared to a historical control group. Patients in the block group received a 0.5% ropivacaine bolus preoperatively followed by a 0.2% ropivacaine infusion begun postoperatively. No other changes were made to the perioperative care protocol. The primary outcome was opioid consumption. Secondary outcomes were time to extubation and length of stay. Twenty-eight patients received continuous erector spinae plane blocks and fifty patients served as historic controls. Patients who received blocks consumed less opioids, expressed as oral morphine equivalents, both intraoperatively (34 ± 17 vs. 224 ± 125 mg) and during their hospitalization (224 ± 108 vs. 461 ± 185 mg). Patients who received blocks had shorter times to extubation (126 ± 87 vs. 257 ± 188 min) and lengths of stay in the intensive care unit (35 ± 17 vs. 58 ± 42 h) and hospital (5.6 ± 1.6 vs. 7.7 ± 4.6 days). Continuous erector spinae plane blocks placed prior to open cardiac surgical procedures reduced opioid consumption, time to extubation, and length of stay compared to a standard perioperative pathway.
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Vaughan et al. (2021) conducted a cohort in Open cardiac surgery (n=78). Continuous bilateral erector spinae plane blocks vs. Historical control group (standard practice) was evaluated on Opioid consumption during hospitalization (oral morphine equivalents in mg). Continuous bilateral erector spinae plane blocks prior to open cardiac surgery reduced opioid consumption during hospitalization compared to historical controls (224 vs. 461 mg).
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