A Randomized Double-Blind Controlled Trial to Assess the Efficacy of Ultrasound-Guided Erector Spinae Plane Block in Cardiac Surgery

Athar, Manazir; Parveen, Sania; Yadav, Mayank; Siddiqui, Obaid Ahmed; Nasreen, Farah; Ali, Shahna; Haseen, Mohd Azam

doi:10.1053/j.jvca.2021.03.009

Cited by 46 publications

(52 citation statements)

References 17 publications

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“…In the ESP block group, 24-hour cumulative morphine consumption was observed to be reduced by at least 65%, similar to the study of Athar et al (14). Along with the decrease in morphine consumption, the incidence of nausea and vomiting was also found to be significantly lower for the ESP group.…”

Section: Discussionsupporting

confidence: 87%

“…ESP block has been used safely by many authors for postoperative pain in thorax, abdomen, extremity, and spinal surgeries (6). However, there are a limited number of prospective randomized controlled trials for cardiac surgeries (7,(12)(13)(14). Krishna 12) also compared the patient group that did not undergo block operation in cardiac surgery with the patient group that underwent continuous ESP using 0.2% ropivacaine, and they reported that there was a significant reduction in postoperative morphine consumption and mobilization durations.…”

Section: Discussionmentioning

confidence: 99%

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Postoperative analgesic effectiveness of bilateral erector spinae plane block for adult cardiac surgery: a randomized controlled trial

Güven

ERTÜRK

Ersoy

2022

Journal of Health Sciences and Medicine

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Introduction: There are few randomized controlled trials examining the effectiveness of bilateral Erector Spinae Plane Block (ESP) with patients undergoing cardiac surgery. The effect of bilateral ESP block on postoperative pain levels and analgesic consumption for patients undergoing open-heart surgery was examined in this single-blind, randomized, controlled trial.Material and Method: 54 patients who underwent cardiac surgery with open median sternotomy under general anesthesia between May 2020 and June 2021 were included in the study. Patients were randomized into two groups, each consisting of 27 patients, one with 40 ml of 0.25% bupivacaine and bilateral ESP block, the other with no block implementation (control group). Demographic data, operation type, length of stay in the Intensive Care Unit (ICU), numerical rating scale (NRS) values in the first 24 hours after extubation, and morphine consumption values of the patients were recorded for the study.Results: In the study, 4 patients were excluded from follow-up due to prolonged intubation in the postoperative period. The data of a total of 50 patients (ESP group n=25; Control group n=25) were analyzed. The duration before first analgesic (mean±SD: 459.2±92.8 min.) of the ESP group was statistically longer than those in the control group (mean±SD: 142.0±56.6 min.) (p<0.001). The total length of stay in the ICU and rate of nausea-vomiting were lower for the ESP group than for the control group (p<0.05). Total morphine consumption (mean±SD: 5.1±3.1 mg) of the ESP group in the first 24 hours was statistically lower (p<0.001) compared to the consumption of the control group (mean±SD: 14.8±4.2 mg). NRS scores were significantly lower for the ESP group at postoperative 1st, 2nd, 4th, 6th, and 8th hours compared to the control group (p<0.05). Conclusion:ESP block applied bilaterally in adult cardiac surgeries decreased postoperative pain scores and morphine consumption. At the same time, it was observed that the length of stay of the patients in the ICU was reduced and there were no complications.

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Section: Discussionsupporting

confidence: 87%

Section: Discussionmentioning

confidence: 99%

Postoperative analgesic effectiveness of bilateral erector spinae plane block for adult cardiac surgery: a randomized controlled trial

Güven

ERTÜRK

Ersoy

2022

Journal of Health Sciences and Medicine

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“…The remaining 155 articles were fully reviewed. Finally, 52 RCTs with 3000 patients were included in the current review, 10–12 , 14 , 21–68 each reporting the preplanned primary outcomes. Interestingly, all studies are published between 2018 and 2021, showing that ESPB is a novel technique.…”

Section: Resultsmentioning

confidence: 99%

“…Out of the 52 RCTs, 11 were about breast surgeries, 24–26 , 31 , 36 , 38 , 39 , 47 , 48 , 54 , 64 15 were about orthopedic surgeries, 10 , 11 , 21–23 , 27 , 28 , 32 , 33 , 50 , 52 , 53 , 56 , 57 , 60 5 were about thoracoscopic surgeries, 12 , 25 , 34 , 58 , 59 6 were about cholecystectomy, 29 , 30 , 41 , 45 , 63 , 65 6 were about nephrolithotomy, 37 , 44 , 49 , 61 , 62 , 68 2 were about cardiac surgeries, 14 , 42 and 7 were others. 40 , 43 , 46 , 51 , 55 , 66 , 67 The characteristics of enrolled 52 studies were listed in the Table 1 .…”

Section: Resultsmentioning

confidence: 99%

“…Erector spinae plane block (ESPB), one of novel regional techniques, was described in 2016 by Forero et al 8 and it had been performed for breast surgery, 9 lumbar spine surgery, 10 , 11 thoracoscopic surgery, 12 cholecystectomy, 13 and cardiac surgery. 14 Despite ESPB is widely used in many regions to treat perioperative pain, its benefits are still somewhat controversial. Several meta-analyses have shown that ESPB can provide sufficient analgesic effects and reduce postoperative opioid consumption; however, the results are not convincing enough due to the small number of cases included and significant heterogeneity among studies.…”

Section: Introductionmentioning

confidence: 99%

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The Effect of Single-Shot Erector Spinae Plane Block (ESPB) on Opioid Consumption for Various Surgeries: A Meta-Analysis of Randomized Controlled Trials

Cui¹,

Wang²,

Yang³

et al. 2022

JPR

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Study Objective Pain management plays a pivotal role in enhanced recovery after surgery (ERAS). Erector spinae plane block (ESPB) is widely used in many regions to treat perioperative pain, but its benefits are still somewhat controversial. We, therefore, intent to systematically review the available literature on ESPB, to elucidate its effects on opioid-sparing analgesia, and summarize its potential complications. Design Systematic review of randomized controlled trials (RCTs) with meta-analysis. Setting Postoperative opioid consumption for various surgeries. Patients Patients undergoing various surgeries. Intervention We searched relevant studies in PubMed, EMBASE, Medline, and the Cochrane Library up to May 16, 2021. All prospective and RCTs that compared ESPB and sham block or no block were enrolled. Measurements The primary outcomes were postoperative opioid consumption during the first 24 hours. The secondary outcomes were the requirement of rescue analgesia, time to first rescue analgesic and ESPB-related adverse events. Results We included 52 trials that reported postoperative opioid consumption during the first 24 hours. The results presented that compared to control group (ie, no intervention or a sham block), ESPB reduced the accumulated opioid consumption during the first 24 h after surgery [mean difference (MD) of − 12.83 (95% CI: − 17.29 to − 8.38; p < 0.001) mg; I 2 = 100%]. Besides, ESPB could prolong time to first rescue analgesia after surgery [SMD = 5.31; 95% CI 4.01–6.61; p < 0.001; I 2 = 97%]. The number of patients who received rescue analgesia after surgery in the ESPB group was less than that in the control group (OR 0.13; 95% CI 0.09, 0.21; p < 0.001; I 2 = 54%), and the incidence of PONV was lower in the ESPB group (OR 0.51; 95% CI 0.43, 0.62; p < 0.001; I 2 = 19%). Conclusion ESPB is an effective technique on pain management with few complications.

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Erector spinae plane block for postoperative pain

Schnabel,

Weibel,

Pogatzki-Zahn

et al. 2023

Cochrane Database of Systematic Reviews

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A Randomized Double-Blind Controlled Trial to Assess the Efficacy of Ultrasound-Guided Erector Spinae Plane Block in Cardiac Surgery

Cited by 46 publications

References 17 publications

Postoperative analgesic effectiveness of bilateral erector spinae plane block for adult cardiac surgery: a randomized controlled trial

Postoperative analgesic effectiveness of bilateral erector spinae plane block for adult cardiac surgery: a randomized controlled trial

The Effect of Single-Shot Erector Spinae Plane Block (ESPB) on Opioid Consumption for Various Surgeries: A Meta-Analysis of Randomized Controlled Trials

Erector spinae plane block for postoperative pain

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