Background and Aims Many patients that undergo cardiac surgery via median sternotomy experience uncontrolled postoperative pain leading to prolonged intubation, impaired recovery, and the development of chronic pain. The erector spinae plane (ESP) block and the pecto-intercostal fascial (PIF) plane block have been used as multimodal analgesia for sternotomy pain. The purpose of this study was to compare the analgesic efficacy of ESP blocks and PIF blocks versus no block in patients under general anesthesia undergoing sternotomy for cardiac surgery.

Methods This randomized prospective control trial was conducted at an academic care center and included 90 participants. The primary endpoint was opioid consumption during post operative days (POD) 0, 1, 2, 3, 4, and 5. Secondary endpoints included Visual Analog Scale pain scores, time to extubation, ICU length of stay (LOS), total postoperative LOS, and nausea/vomiting after extubation.

Results Among the patients included, 30 received bilateral ESP block, 30 received bilateral PIF block, and 30 received no block. No significant differences in post-operative opioid consumption as measured in MME on POD 0, 1, 2, 3, 4, or 5 were seen between groups. When analyzing VAS scores at POD 0,1,2, and 3 between groups, there was a statistically significant difference between the ESP block group compared to the control group.

Conclusions These results indicate that the administration of ESP or PIF block for sternotomy does not modulate opioid use throughout the average ICU LOS duration for these patients, as compared to the control however may contribute to improved patient experience as indicated by lower pain scores.