Abstract | OBJECTIVES: To examine the analgesic efficacy of bilateral erector spinae plane (ESP) block compared with conventional treatment for pain after cardiac surgery in adult patients. DESIGN: A prospective, randomized, controlled, single-blinded study. SETTING: Single-center tertiary teaching hospital. PARTICIPANTS: INTERVENTIONS: Patients were randomized into 2 groups. Patients in group 1 (ESP block group, n = 53) received ultrasound-guided bilateral ESP block with 3 mg/kg of 0.375% ropivacaine before anesthesia induction at the T6 transverse process level. Patients in group 2 ( paracetamol and tramadol group, n = 53) received paracetamol (1 gm every 6 hours) and tramadol (50 mg every 8 hours) intravenously in the postoperative period. The primary study outcome was to evaluate pain at rest using an 11-point numeric rating scale (NRS). Mann-Whitney U test was used for comparing NRS scores. MEASUREMENTS AND MAIN RESULTS: The postoperative pain level after extubation and duration of analgesia during which NRS was < 4 of 10 was compared between the groups. The median pain score at rest after extubation in group 1 was 0 of 10 until hour 6, 3 of 10 at hour 8, and 4 of 10 at hours 10 and 12 postextubation. These were significantly less in comparison with group 2 (p = 0.0001). Patients in group 1 had a significantly higher mean duration of analgesia (8.98 ± 0.14 hours), during which NRS was < 4 of 10, compared with group 2 (4.60 ± 0.12 hours) (p = 0.0001). CONCLUSION: ESP block safely provided significantly better pain relief at rest for longer duration as compared to intravenous paracetamol and tramadol.
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Authors | Siva N Krishna, Sandeep Chauhan, Debesh Bhoi, Brajesh Kaushal, Suruchi Hasija, Tsering Sangdup, Akshay K Bisoi |
Journal | Journal of cardiothoracic and vascular anesthesia
(J Cardiothorac Vasc Anesth)
Vol. 33
Issue 2
Pg. 368-375
(02 2019)
ISSN: 1532-8422 [Electronic] United States |
PMID | 30055991
(Publication Type: Journal Article, Randomized Controlled Trial)
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Copyright | Copyright © 2018 Elsevier Inc. All rights reserved. |
Chemical References |
- Analgesics, Non-Narcotic
- Analgesics, Opioid
- Acetaminophen
- Tramadol
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Topics |
- Abdominal Muscles
- Acetaminophen
(administration & dosage)
- Acute Pain
(diagnosis, therapy)
- Adult
- Analgesia
(methods)
- Analgesics, Non-Narcotic
(administration & dosage)
- Analgesics, Opioid
(administration & dosage)
- Cardiac Surgical Procedures
(adverse effects)
- Drug Therapy, Combination
- Female
- Humans
- Injections, Intravenous
- Male
- Middle Aged
- Pain Measurement
- Pain, Postoperative
(diagnosis, therapy)
- Prospective Studies
- Single-Blind Method
- Tramadol
(administration & dosage)
- Treatment Outcome
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