Using the blockade of interfascial space of the <i>erector spinae</i> muscle (<i>erector spinae</i> plane block) in minimally invasive coronary bypass surgery: prospective randomized study

Abstract

BACKGROUND: Despite the successful development of cardio-anesthesiology, no consensus exists on the preferred anesthesia method for coronary artery bypass grafting. OBJECTIVE: To evaluate the effectiveness of perioperative analgesia in minimally invasive coronary artery bypass surgery (MIDCAB) using ultrasound-assisted blockade in erector spinae plane (ESP). MATERIALS AND METHODS: A prospective, two-center, randomized study included 37 patients who underwent MIDCAB surgery. In group 1, before the induction of general anesthesia, an ESP block was performed; in group 2, the operation was performed only under general anesthesia. RESULTS: The consumption of fentanyl for anesthesia differed in groups 1 (ESP block) and 2 (general anesthesia): 0.9 (0.8; 1.0) mg vs 3.0 (2.6; 3.2) mg (p 0.01). The norepinephrine dosage was higher in group 2 than in group 1: 0.18 (0.16; 0.22) mcg/kg/min vs 0.05 (0.04; 0.06) mcg/kg/min (p 0.01). Postoperatively, the pain score was lower in group 1 than in group 2, and no additional opioids were required during the first 34 h after extubation. Thereafter, no differences in pain scores were observed between the groups. CONCLUSION: The use of an ESP block with a single injection of a local anesthetic is effective in reducing the total dosage of fentanyl used during surgery, dosage of norepinephrine, and mechanical ventilation and improve the quality of postoperative analgesia during MIDCAB.