Effectiveness of bilateral erector spinae plane block on intraoperative requirement of fentanyl in patients undergoing cardiac surgery: a randomized controlled interventional study

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Abstract

Background and objectives
Erector spinae plane block (ESPB) is a newly defined and effective interfacial plane block. Cardiac surgeries are performed mainly via a median sternotomy leads to significant postoperative pain. Multiple studies have confirmed that ESPB is effective in cardiothoracic and abdominal surgeries. This study aimed to compare the efficacy of ESPB in two groups (group A and group B) for the intraoperative requirement of fentanyl (entropy index guided), hemodynamic variables, need of first rescue analgesia in the postoperative period, and side effects.
Settings and design
The study was designed as a prospective, randomized, control, hospital-based interventional study.
Patients and methods
A total of 60 patients, 18–65 years old of either sex who underwent cardiothoracic surgery by midline sternotomy under general anesthesia, were divided into either group A (=30), which received ultrasound-guided bilateral ESPB by 25 ml 0.5% ropivacaine with dexmedetomidine 0.5 μg/kg with general anesthesia), or group B (=30), which received general anesthesia without block.
Statistical analysis used
To observe the difference in quantitative variables between both groups Student’s test/analysis of variance test was performed. The Fisher’s exact or test was used to establish the association between qualitative variables.
Results
The median requirement of fentanyl (μg/kg/h) in group A and group B was 1.97 (1.43–2.83) and 2.55 (1.55–3.19). This difference was statistically nonsignificant (=0.348). The mean time of first rescue analgesia in group A and group B was 10.9±8.6 and 7.1±4.4 h, respectively (<0.05). Demographically both groups were comparable.
Conclusions
ESPB produced safe and effective analgesia in the postoperative period following cardiac surgery.

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