Format

Send to

Choose Destination
J Cardiothorac Vasc Anesth. 2019 Feb;33(2):368-375. doi: 10.1053/j.jvca.2018.05.050. Epub 2018 Jun 4.

Bilateral Erector Spinae Plane Block for Acute Post-Surgical Pain in Adult Cardiac Surgical Patients: A Randomized Controlled Trial.

Author information

1
Department of Cardiac Anesthesiology, Cardio and Neurosciences Center, All India Institute of Medical Sciences, New Delhi, India. Electronic address: krissiva@live.in.
2
Department of Cardiac Anesthesiology, Cardio and Neurosciences Center, All India Institute of Medical Sciences, New Delhi, India.
3
Department of Anesthesiology, Pain Medicine and Critical Care, All India Institute of Medical Sciences, New Delhi, India.
4
Department of Cardiothoracic and Vascular Surgery, Cardio and Neurosciences Center, All India Institute of Medical Sciences, New Delhi, India.

Abstract

OBJECTIVES:

To examine the analgesic efficacy of bilateral erector spinae plane (ESP) block compared with conventional treatment for pain after cardiac surgery in adult patients.

DESIGN:

A prospective, randomized, controlled, single-blinded study.

SETTING:

Single-center tertiary teaching hospital.

PARTICIPANTS:

One hundred and six adult patients undergoing elective cardiac surgery with cardiopulmonary bypass.

INTERVENTIONS:

Patients were randomized into 2 groups. Patients in group 1 (ESP block group, n = 53) received ultrasound-guided bilateral ESP block with 3 mg/kg of 0.375% ropivacaine before anesthesia induction at the T6 transverse process level. Patients in group 2 (paracetamol and tramadol group, n = 53) received paracetamol (1 gm every 6 hours) and tramadol (50 mg every 8 hours) intravenously in the postoperative period. The primary study outcome was to evaluate pain at rest using an 11-point numeric rating scale (NRS). Mann-Whitney U test was used for comparing NRS scores.

MEASUREMENTS AND MAIN RESULTS:

The postoperative pain level after extubation and duration of analgesia during which NRS was < 4 of 10 was compared between the groups. The median pain score at rest after extubation in group 1 was 0 of 10 until hour 6, 3 of 10 at hour 8, and 4 of 10 at hours 10 and 12 postextubation. These were significantly less in comparison with group 2 (p = 0.0001). Patients in group 1 had a significantly higher mean duration of analgesia (8.98 ± 0.14 hours), during which NRS was < 4 of 10, compared with group 2 (4.60 ± 0.12 hours) (p = 0.0001).

CONCLUSION:

ESP block safely provided significantly better pain relief at rest for longer duration as compared to intravenous paracetamol and tramadol.

KEYWORDS:

adult cardiac surgery; erector spinae plane block; fascial plane block; numeric rating scale; postoperative pain

PMID:
30055991
DOI:
10.1053/j.jvca.2018.05.050
[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Elsevier Science
Loading ...
Support Center