The Analgesic Effect of Ultrasound-guided Erector Spinae Plane Block in Median Sternotomy Cardiac Surgery in Adults: A Systematic Review and Meta-analysis of Randomized Controlled Trials

Wang, Wenzhu; Yang, Weilin; Liu, Ang; Liu, Jian; Yuan, Changxiu

doi:10.1053/j.jvca.2024.05.019

Journal of Cardiothoracic and Vascular Anesthesia

2024

DOI: 10.1053/j.jvca.2024.05.019

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The Analgesic Effect of Ultrasound-guided Erector Spinae Plane Block in Median Sternotomy Cardiac Surgery in Adults: A Systematic Review and Meta-analysis of Randomized Controlled Trials

Wenzhu Wang,

Weilin Yang,

Ang Liu

et al.

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Cited by 2 publications

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Perioperative pain management for cardiac surgery

Yakubi,

Curtis,

Anwar

2024

Current Opinion in Anaesthesiology

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Purpose of review Acute postsurgical pain after cardiac surgery is challenging to treat. Adverse effects related to the high dose opioids which have traditionally been used perioperatively in cardiac surgery have led to the adoption of alternative analgesic strategies. This review aims to highlight current evidence-based approaches to managing pain after cardiac surgery Recent findings Current evidence and international guidelines support the use of multimodal analgesics for managing perioperative pain after cardiac surgery. Regional anaesthesia in the form of fascial plane blocks, such as the erector spinae plane and parasternal intercostal plane blocks, are effective and safe techniques for anticoagulated cardiac surgery patients. Transitional pain services are multidisciplinary programmes that bridge the gap between inpatient and outpatient care for these patients. Summary This paper reviews advancements in perioperative pain management for cardiac surgery patients, emphasising the shift from high-dose opioids to multimodal analgesia and regional anaesthetic techniques, and highlighting the role of multidisciplinary transitional pain services.

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Perioperative pain management for cardiac surgery

Yakubi,

Curtis,

Anwar

2024

Current Opinion in Anaesthesiology

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Erector spinae plane block versus intravenous opioid for analgesia in pediatric cardiac surgery: A systematic review and meta‐analysis

Lombardi,

Pereira,

Amaral

et al. 2024

Pediatric Anesthesia

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IntroductionThe erector spinae plane block (ESPB) has recently emerged as a regional anesthesia technique for perioperative pain management in pediatric cardiac surgery. However, evidence comparing its effectiveness with intravenous (IV) opioid‐based analgesia is limited. We aimed to evaluate and compare the analgesic efficacy of ESPB versus IV opioids in this setting.MethodsWe systematically reviewed and meta‐analyzed studies comparing ESPB with IV opioid analgesia in pediatric cardiac surgeries with midline sternotomy. Primary outcomes were intraoperative fentanyl consumption and intensive care unit (ICU) length of stay (LOS). Secondary outcomes included postoperative opioid consumption, time to first rescue analgesia, pain scores, postoperative vomiting and other complications, extubation time, and hospital LOS. Statistical analyses were performed using RStudio version 4.2.3.ResultsFive studies with 384 patients were included, with 178 receiving ESPB. ESPB significantly reduced intraoperative fentanyl use (MD −1.90 μg.kg−1; 95% CI −3.15 to −0.66 μg.kg−1; p = .003; I2 = 58%) and ICU LOS (MD ‐3.50 h; 95% CI ‐4.32 to −2.69 h; p < .0001; I2 = 0%). No significant differences were found in the remaining outcomes.ConclusionOur findings suggest the ESPB might be an important adjunct to enhancing analgesia for midline sternotomies in pediatric cardiac surgery, potentially reducing intraoperative opioid requirements and ICU LOS.PROSPERO RegistrationCRD 42024526961.

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The Analgesic Effect of Ultrasound-guided Erector Spinae Plane Block in Median Sternotomy Cardiac Surgery in Adults: A Systematic Review and Meta-analysis of Randomized Controlled Trials

Cited by 2 publications

References 46 publications

Perioperative pain management for cardiac surgery

Perioperative pain management for cardiac surgery

Erector spinae plane block versus intravenous opioid for analgesia in pediatric cardiac surgery: A systematic review and meta‐analysis

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