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EP075 Pain management in minimally invasive cardiac surgery: a systematic review and meta-analysis of the erector spinae plane block versus control
  1. Marcela Tatsch Terres1,
  2. Maria Luísa Assis2,
  3. Rita Gonçalves Cardoso3 and
  4. Sara Amaral4
  1. 1Anesthesiology, Universidade do Sul de Santa Catarina, Palhoça, Brazil
  2. 2Anesthesiology, Hospital das Clínicas de Porto Alegre, Porto Alegre, Brazil
  3. 3Anesthesiology, Hospital da Senhora da Oliveira – Guimarães, Guimarães, Portugal
  4. 4Anesthesiology, Hospital Regional Deputado Afonso Guizzo, Ararangua, Brazil


Background and Aims Minimally invasive cardiac surgery (MICS) has emerged as a promising approach for cardiac procedures, improving patient outcomes. However, postoperative pain management remains a significant challenge in this field. Various regional anesthesia techniques have been investigated with the erector spinae plane block (ESPB) being one of the relatively recent advancements. Our aim is to compare the efficacy of this block with a control group in patients undergoing MICS.

Methods PubMed, EMBASE, and Cochrane were searched for studies comparing the ESPB to control (non-block group). The outcomes included opioid consumption, postoperative duration of mechanical ventilation, and intensive care unit (ICU) and hospital lengths of stay. RevMan 5.4 analyzed data.

Results The present study systematically analyzed a total of six studies encompassing a sample size of 717 patients, with 43.2% of them undergoing the erector spinae plane block (ESPB). Our findings revealed that the implementation of ESPB yielded a statistically significant reduction in the duration of mechanical ventilation when compared to the control group (figure 1). Conversely, no significant differences were observed between the ESPB and control groups in relation to opioid consumption (figure 2). Furthermore, there were no significant disparities detected between the groups concerning the lengths of stay in the intensive care unit (ICU) and hospital (figure 3).

Abstract EP075 Figure 1

Duration of mechanical ventilation was lower in the ESPB group

Abstract EP075 Figure 2

There was no significant difference in opioid consumption at 24 hours (Figure 2A) or at 72 hours (Figure 2B)

Abstract EP075 Figure 3

There was no significant difference in length of stay in the intensive care unit (Figure 3A) or in the hospital (Figure 3B)

Conclusions Based on our findings, it can be inferred that the implementation of the ESPB may effectively decrease the duration of mechanical ventilation. However, in order to draw more comprehensive conclusions, further investigations involving a larger number of patients are warranted.

  • erector spinae plane block
  • ESP block
  • ESP
  • cardiac surgery
  • minimally invasive cardiac surgery
  • MICS
  • review

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