In a retrospective clinical trial in the Journal of Cardiothoracic Surgery, investigators examined regional anesthesia techniques for managing perioperative pain in patients undergoing coronary artery bypass surgery. The researchers concluded that the most effective technique appeared to be double injection of the erector spinae plane block. The team therefore suggested the use of fascial plane blocks during cardiac surgery, which also supported extubation in the operating room, wrote the lead author, Sami Kaan Cosarcan.
A total of 221 patients who had undergone coronary bypass surgery at the authors’ center were retrospectively enrolled in the study.
Among the cohort, 91% were extubated in the operating room, none received balloon pump support, and 20 were transferred to the cardiovascular intensive care unit while intubated, of which 2 received regional anesthesia. In these 2 patients, further analysis showed that the regional anesthesia significantly lowered both intraoperative and postoperative opioid consumption after coronary artery bypass surgery.
The study was limited by its retrospective design. Furthermore, patients’ pain scores were collected via a uniform scale, and follow-ups were performed by intensive care and pain nurses. Moreover, the authors acknowledged that mobilization and length of intensive care unit stay were used as recovery criteria, “although it is controversial whether or not they determine early recovery.”
Ultimately, the study’s collaborators reported that “regional anesthesia techniques severely limit opioid consumption during cardiac surgery,” and they proposed that “their importance will gradually increase in terms of rapid recovery criteria.”