Erector Muscle Spinae Plane Block in Open Heart Surgery - Effect on Perioperative Opioid Consumption

• Status: Completed
• Trial end date: 2021-05-31
• Target enrollment: 0
• Participant gender: All

Summary

With the advent of ultrasound (US) guidance, use of regional anaesthesia (RA) is poised to grow and evolve. Recently, cardiac surgery has benefited from newer US guided interfascial techniques as they promise to fulfil all the prerequisites of an enhanced recovery after surgery (ERAS) strategy(1,2).

The erector spinae plane (ESP) block represents such an alternative(3). Speed and ease of performance are paramount to encourage spread of its use. Hence, the scope of this trial is to investigate the effects on perioperative opioid consumption and several other secondary outcomes of a minimalist approach encompassing a bilateral single shot ESP block when applied as an adjunct to general anaesthesia.

• Phase: Phase 4
• Accepts Healthy Volunteers?: No

Details

• Lead Sponsor: Institutul de Urgenţă pentru Boli Cardiovasculare Prof.Dr. C.C. Iliescu
• Treatments: Analgesics, Opioid; Anesthetics; Anesthetics, General; Fentanyl; Ropivacaine

Criteria

Inclusion Criteria:

1. Informed Consent.

2. Elective heart surgery with sternotomy and bypass.

3. Hemodynamic stability prior to induction (no chest pain, SAP > 100 mmHg, MAP ≥ 60 mmHg, 50 < HR < 100 bpm).

4. Sinus rhythm.

Exclusion Criteria:

1. Known allergy to any of the medications used in the study.

2. BMI > 35.

3. Patient refusal to participate in the study.

4. Coagulopathy (INR > 1.5, APTT > 45, Fibrinogen < 150 mg/dl).

5. Non-elective/emergent and/or redo surgery.

6. ASA ≥ 4.

7. Any preoperative hemodynamic support (mechanical or pharmaceutical).

8. Severe LV dysfunction (LVEF ≤ 30%).

9. Severe RV dysfunction or PHT (RVEF ≤ 30%).