Erector spinae plane and superficial parasternal intercostal plane blocks vs. control for sternotomy in cardiac surgery: A prospective, randomized trial.
Ali Shariat, Natalia Egorova, Yuxia Ouyang et al.
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In 30 seconds
This prospective, randomized controlled trial compared standard therapy with erector spinae plane (ESP) or superficial parasternal intercostal plane blocks in 271 adults undergoing elective sternotomy for cardiac surgery. Opioid consumption did not differ significantly between groups during surgery or on postoperative days 0–2; on day 3, consumption differed among groups, driven by lower use in the ESP group (p = 0.047). Maximum pain scores were significantly lower with both blocks than with control on postoperative days 1 (p < 0.001), 2 (p < 0.001), and 3 (p = 0.002).
Key findings
- Opioid consumption did not differ significantly during surgery or on postoperative days 0, 1, and 2.
- On postoperative day 3, opioid consumption differed among groups, driven by lower use in the ESP group (p = 0.047).
- Maximum pain scores were lower with both blocks than control on postoperative days 1 (p < 0.001), 2 (p < 0.001), and 3 (p = 0.002).
Why it matters
Sternotomy pain can be difficult to manage, and these findings suggest that either regional block may improve postoperative pain scores when added to multimodal analgesia. The lack of an opioid-consumption difference across most measured periods indicates that improved pain scores did not translate into a consistent reduction in opioid use in this trial.
What to keep in mind
The trial was conducted at a single hospital, and the abstract does not report effect sizes for the pain-score or opioid-consumption differences.