Effect of Continuous Erector Spinae Plane Block on Postoperative Recovery in Patients Undergoing Minimally Invasive Cardiac Surgery: A Prospective, Randomized Controlled Clinical Trial.

Abstract

Objective: To investigate whether continuous erector spinae plane block (ESPB) improves the quality of recovery (QoR) and decreases postoperative acute and chronic pain in patients undergoing minimally invasive cardiac surgery.

Methods: This was a single-center, double-blind, prospective, randomized, placebo-controlled trial. A total of 120 patients were randomized to groups at a 1:1 ratio. They received general anaesthesia and an ESP catheter (ropivacaine or normal saline) before surgery, and received patient-controlled intravenous analgesia with sufentanil and continuous ESPB with a pulse injection of 8 mL (ropivacaine or normal saline) per h after 20 mL of the experimental drug was administered at the end of surgery. The primary outcome was the 15-item quality of recovery scale (QoR-15) score at 24 h after surgery. The secondary outcomes included the severity of pain, sufentanil consumption, incidence of rescue analgesia, and proportion of patients with chronic pain.

Results: The QoR-15 score was greater in the ESPB group than in the control group at 24 h after surgery [112 (108-118) vs. 109 (101-114), P=0.023]. ESPB was associated with a lower cough visual analogue scale (VAS) score (44 vs. 47, P=0.001), resting VAS score (28 vs. 35.5, P=0.003), sufentanil consumption (104.8 µg vs. 145.5 µg, P=0.000), and incidence of rescue analgesia (20.0% vs. 43.3%, P=0.006).

Conclusion: Continuous ESPB mildly improved the QoR-15 score in patients undergoing minimally invasive cardiac surgery and reduced postoperative pain scores, opioid consumption, and the incidence of rescue analgesia.