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Background and Aims Early extubation and optimal pain control and minimizing stress response is an important aspect after Minimally Invasive Cardiac Surgery (MICS). Erector Spinae Plane Block (ESPB) and Serratus Anterior Plane Block (SAPB) are recently described techniques for chest wall analgesia. Their role in MICS is yet to be well determined. We tried to assess efficacy and safety of ultrasound guided SAPB compared to ESPB in the management of pain and stress response in patient undergoing MICS

Methods Patients undergoing MICS for coronary artery bypass grafting were randomly assigned into two groups. Both SAPB group (group A) and ESPB (group B) were given 0.2% of 20 ml Ropivacaine followed by catheter insertion for continuous infiltration at the end of the procedure. The primary outcome measured were changes in VAS Score (Pain) and cortisol levels (for stress response) in both the groups

Results There was no significant difference of mean VAS score between the two groups. Hemodynamic parameters were stable in both the groups. Stress response in the form of serum cortisol level showed no major difference between the two groups. There was a statistically significant difference in the spirometry values between the two groups. The duration of ICU stay was significantly lower in the ESPB group as compared to SAPB group

Conclusions Both ESPB and SAPB offer good quality of analgesia in MICS.ESPB is better as it blocks both dorsal and ventral rami of the thoracic spinal nerves and elicits some degree of sympathetic blockade, while SAPB, targets only branches of the nerve