Background and Aims Although the effectiveness of erector spinae plane block (ESPB) in cardiac surgery has been shown, but the optimal volume of ESPB in CABG surgery remains unclear. We hypothesized that using larger volumes of local anesthetic in the ESPB would result in greater dermatomal blockade. The aim of this study is to determine the analgesic efficacy of ESP block with two different volumes in CABG patients.
Methods This prospective,randomized study was conducted in adult patients undergoing CABG surgery with cardiopulmonary bypass. Group-20 received 20ml of 0.25% bupivacaine per-side in ESPB and Group-30, 30ml of 0.25% bupivacaine per-side. Following extubation, tramadol 100mg as rescue analgesia was given to patients of NRS>4. Postoperative sternotomy and chest tube pain was evaluated using the NRS at rest and during coughing after extubation.
Results 70 patients were analyzed. There were significant differences between the groups regarding rescue analgesic was higher in the group 20ml (25/35vs2/35,p<0.001) and the time of the first rescue analgesic requirement. The mean time±std were 11.26±9.57 hours and 24.03±4.12 hours in the group 20ml and the group 30ml,(p<0.001). The median-(IQR) NRS scores, both at sternotomy and chest tubes, were significantly lower in the group 30ml at the different time points after the surgery (p<0.05).
Conclusions The ESP block performed with a volume of 30 ml, less pain was observed in the sternum and chest tube region, less rescue analgesic requirement, and late first rescue analgesic requirement time. 30 ml can be effective in chest tube and sternum pain in cardiac surgery.
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