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

To examine the efficacy of continuous unilateral erector spinae plane (ESP) blocks in minimally invasive cardiac surgery patients.

A retrospective nonrandomized study.

At a single-center, tertiary academic institution.

The study comprised 129 adult patients undergoing minimally invasive cardiac surgery with cardiopulmonary bypass or extracorporeal membrane oxygenation.

Patient data were retrospectively collected and compared. Group 1 patients received ultrasound-guided ESP blocks, and group 2 patients underwent conventional intraoperative management without ESP blocks. After intubation in the group 1 cohort, 20-to- 25 mL of 0.25% ropivacaine were deposited beneath the erector spinae plane, along with catheter placement for continuous postoperative infusion.

Patient characteristics (ie, age, sex, and comorbidities) were well-matched between both cohorts. The total 48-hour opioid consumption, as measured in morphine equivalents (mg), was significantly decreased in patients receiving erector spinae plane blocks compared to patients receiving conventional therapy (30.24 mg ± 23.8 v 47.82 mg ± 53.6, p = 0.04). The length of stay in the intensive care unit (ICU) also was reduced in the treatment group in comparison to the control group (1.99 days ± 1.7 v 2.65 days ± 2.4, p = 0.03). Lastly, patients receiving the blocks benefitted from a decrease in overall hospital length of stay when compared to the control group (5.93 days ± 2.4 v 7.35 days ± 5.8, p = 0.04).

Erector spinae plane catheter use may safely improve postoperative measures, including decreased opioid consumption and improved pain relief, as well as reductions in ICU and hospital lengths of stay in patients undergoing minimally invasive cardiac surgery.