Erector Spinae Plane Catheter Analgesia in Minimally Invasive Mitral Valve Surgery: A Retrospective Case-Control...

Area of Science:

• Anesthesiology
• Cardiothoracic Surgery
• Pain Management

Background:

• Enhanced recovery programs aim to optimize surgical patient outcomes.
• Minimally invasive mitral valve replacement surgery presents unique pain management challenges.
• The erector spinae plane (ESP) block is a regional anesthesia technique with potential analgesic benefits.

Purpose of the Study:

• To assess the feasibility of using the ESP block in an enhanced recovery pathway.
• To evaluate the impact of ESP block on postoperative opioid consumption.
• To determine the effect of ESP block on perioperative outcomes in minimally invasive mitral valve replacement.

Main Methods:

• Retrospective case-control study of 61 patients undergoing minimally invasive mitral valve replacement.
• 23 patients received preoperative ESP block with continuous ropivacaine infusion.
• Primary outcome: 48-hour postoperative opioid consumption (Morphine Milligram Equivalents).

Main Results:

• No statistically significant difference in 48-hour opioid consumption between groups (70 vs 109 MMEs, P=0.16).
• ESP block group showed a significantly shorter hospital length of stay (6.0 vs 7.0 days, P=0.043).
• No significant differences in intraoperative opioid use, extubation time, or ICU length of stay.

Conclusions:

• ESP block demonstrated a potentially clinically significant reduction in postoperative opioid consumption.
• A reduced hospital length of stay was observed in patients receiving the ESP block.
• Further adequately powered prospective trials are warranted to validate the role of ESP catheters in this patient population.