The Use of Unilateral Erector Spinae Plane Block in Minimally Invasive Cardiac Surgery

Area of Science:

• Anesthesiology and Pain Management
• Cardiac Surgery
• Regional Anesthesia

Background:

• Minimally invasive cardiac surgery (MICS) requires effective postoperative pain management.
• Erector spinae plane (ESP) blocks are a regional anesthesia technique with potential benefits for thoracic and cardiac procedures.
• Optimizing pain control can lead to reduced opioid use and shorter hospital stays.

Purpose of the Study:

• To evaluate the efficacy of continuous unilateral erector spinae plane (ESP) blocks in patients undergoing MICS.
• To compare postoperative outcomes, including opioid consumption and length of stay, between patients receiving ESP blocks and those receiving conventional care.

Main Methods:

• A retrospective, nonrandomized study involving 129 adult patients undergoing MICS.
• Patients received either ultrasound-guided ESP blocks with continuous ropivacaine infusion or conventional intraoperative management.
• Data on opioid consumption, ICU length of stay, and hospital length of stay were collected and compared.

Main Results:

• Patients receiving ESP blocks showed significantly decreased 48-hour opioid consumption (30.24 mg ± 23.8 vs. 47.82 mg ± 53.6, p=0.04).
• The ESP block group experienced a reduced length of stay in the intensive care unit (ICU) (1.99 days ± 1.7 vs. 2.65 days ± 2.4, p=0.03).
• Overall hospital length of stay was also significantly shorter in the ESP block group (5.93 days ± 2.4 vs. 7.35 days ± 5.8, p=0.04).

Conclusions:

• Continuous unilateral ESP blocks are a safe and effective adjunct for pain management in MICS patients.
• ESP blocks can lead to significant reductions in opioid requirements and hospital length of stay.
• This technique shows promise for improving postoperative recovery and resource utilization in cardiac surgery.