Efficacy of ultrasound-guided parasternal block in adult cardiac surgery: a meta-analysis of randomized controlled trials

Li, Jing; Lin, Lu; Peng, Jian Wen; He, Shushao; Ye, Wen; Zhang, Ming

doi:10.23736/s0375-9393.22.16272-3

Cited by 19 publications

(6 citation statements)

References 32 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Studies have shown that ESP block decreases postoperative morphine use in cardiac surgery [8,[17][18][19]. A recent meta-analysis has shown that parasternal block could relieve pain and limit opioid-related complications by reducing opioid consumption [20]. In our study, using S-PIP block and ESP block reduced morphine consumption (18.63 ± 6.60 mg vs. 14.41 ± 5.38 mg) by approximately 5 mg.…”

Section: Discussionsupporting

confidence: 50%

Erector spinae plane block versus its combination with superficial parasternal intercostal plane block for postoperative pain after cardiac surgery: a prospective, randomized, double-blind study

et al. 2022

View full text Add to dashboard Cite

Background: We aimed to compare the effectiveness of bilateral erector spinae plane (ESP) block and superficial parasternal intercostal plane (S-PIP) + ESP block in acute post-sternotomy pain following cardiac surgery.Methods: Forty-seven patients aged between 18 and 80 years of age with American Society of Anesthesiologists class II-III due to undergo median sternotomy for cardiac surgery were included in this prospective, randomized, double-blinded study. Following randomization into two groups, one group received bilateral ultrasound-guided ESP and the other S-PIP plus ESP block. Morphine consumption within the first 24 h after surgery was the primary outcome of the study while NRS scores at rest, NRS scores when coughing, time taken until extubation, use of rescue analgesic, presence of nausea/vomiting, length of hospital and intensive care unit (ICU) stay, and patient satisfaction were secondary outcome measures.Results: Morphine use up to 24 h following surgery was statistically significantly different between the ESP block and ESP + S-PIP block groups (18.63 ± 6.60 [15.84-21.41] mg/24 h vs 14. 41 ± 5.38 [12.08-16.74] mg/24 h, p = 0.021). The ESP + S-PIP block group had considerably reduced pain scores compared to the ESP block group across all time points. Rescue analgesics were required in 21 (87.5%) patients in the ESP block group and seven (30.4%) in the ESP + S-PIP group (p < 0.001). PONV, length of stay in the ICU and hospital, and time to extubation were similar between groups. Conclusions:In open cardiac surgery, the combination of ESP and S-PIP blocks lowers pain scores and postoperative morphine requirement of patients.

show abstract

Section: Discussionsupporting

confidence: 50%

Erector spinae plane block versus its combination with superficial parasternal intercostal plane block for postoperative pain after cardiac surgery: a prospective, randomized, double-blind study

et al. 2022

View full text Add to dashboard Cite

show abstract

“…Li et al [ 25 ], in a meta-analysis involving 12 randomized controlled trials (RCTs) with a total of 730 patients, aimed to assess the impact of parasternal block (PSB), including both superficial and deep blocks, on various outcomes in the field of cardiac surgery and postoperative pain management. Patients in the PSB group reported lower numerical rating scale (NRS) scores compared to the control group at specific time points, including at extubation, 4 h after surgery, and 8 h. This indicates that PSB was associated with better pain relief during the immediate postoperative period.…”

Section: Methodsmentioning

confidence: 99%

Fascial plane blocks for cardiothoracic surgery: a narrative review

Capuano,

Sepolvere,

Toscano

et al. 2024

J Anesth Analg Crit Care

View full text Add to dashboard Cite

In recent years, there has been a growing awareness of the limitations and risks associated with the overreliance on opioids in various surgical procedures, including cardiothoracic surgery.This shift on pain management toward reducing reliance on opioids, together with need to improve patient outcomes, alleviate suffering, gain early mobilization after surgery, reduce hospital stay, and improve patient satisfaction and functional recovery, has led to the development and widespread implementation of enhanced recovery after surgery (ERAS) protocols.In this context, fascial plane blocks are emerging as part of a multimodal analgesic in cardiac surgery and as alternatives to conventional neuraxial blocks for thoracic surgery, and there is a growing body of evidence suggesting their effectiveness and safety in providing pain relief for these procedures. In this review, we discuss the most common fascial plane block techniques used in the field of cardiothoracic surgery, offering a comprehensive overview of regional anesthesia techniques and presenting the latest evidence on the use of chest wall plane blocks specifically in this surgical setting.

show abstract

“…Take away: Parasternal blockade may improve perioperative outcomes after cardiac surgery through reductions in opioid use, ventilator time, and length of ICU stay. 32…”

Section: Parasternal Blocksmentioning

confidence: 99%

Regional Anesthesia for Thoracic and Abdominal Surgery: Tips and Tricks for the Surgeon

Allen

McEvoy

2022

The American Surgeon™

View full text Add to dashboard Cite

The use of ultrasound-guided regional anesthesia (UGRA) has flourished over the past two decades with the description of many novel techniques and the incorporation of UGRA into patient care pathways for many types of surgery, including thoracic and abdominal surgery. Numerous facial plane blocks have been developed for analgesia of the chest and abdomen. Though analgesic efficacy varies based on the specific technique, it is important to be aware of the regional anesthesia techniques in common usage, their analgesic distributions, side effect profiles, and efficacy. In this review, we describe fascial plane blocks developed since 2010 as well as older regional anesthesia techniques and provide context for how and why they might be incorporated into patient care pathways. We will provide salient details on block coverage and briefly discuss evidence and relevant controversies around their use.

show abstract

Efficacy of ultrasound-guided parasternal block in adult cardiac surgery: a meta-analysis of randomized controlled trials

Cited by 19 publications

References 32 publications

Erector spinae plane block versus its combination with superficial parasternal intercostal plane block for postoperative pain after cardiac surgery: a prospective, randomized, double-blind study

Erector spinae plane block versus its combination with superficial parasternal intercostal plane block for postoperative pain after cardiac surgery: a prospective, randomized, double-blind study

Fascial plane blocks for cardiothoracic surgery: a narrative review

Regional Anesthesia for Thoracic and Abdominal Surgery: Tips and Tricks for the Surgeon

Contact Info

Product

Resources

About