Using the blockade of interfascial space of the  erector spinae  muscle ( erector spinae  plane block) in minimally invasive coronary bypass surgery: prospective randomized study

Anatoliy V. Stukalov; Стукалов Анатолий Владимирович; Roman E. Lakhin; Лахин Роман Евгеньевич; Evgenii Y. Garbuzov; Гарбузов Евгений Юльевич; Eugene N. Ershov; Ершов Евгений Николаевич; Nikolay V. Stukalov; Стукалов Николай Владимирович

doi:10.17816/RA111806

Using the blockade of interfascial space of the erector spinae muscle (erector spinae plane block) in minimally invasive coronary bypass surgery: prospective randomized study

作者: Stukalov A.V.¹, Lakhin R.E.¹, Garbuzov E.Y.², Ershov E.N.¹, Stukalov N.V.¹
隶属关系:
1. Kirov Military Medical Academy
2. City Hospital No. 40
期: 卷 16, 编号 4 (2022)
页面: 289-302
栏目: Original study articles
##submission.dateSubmitted##: 10.10.2022
##submission.dateAccepted##: 25.01.2023
##submission.datePublished##: 19.12.2022
URL: https://rjraap.com/1993-6508/article/view/111806
DOI: https://doi.org/10.17816/RA111806
ID: 111806

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BACKGROUND: Despite the successful development of cardio-anesthesiology, no consensus exists on the preferred anesthesia method for coronary artery bypass grafting.

OBJECTIVE: To evaluate the effectiveness of perioperative analgesia in minimally invasive coronary artery bypass surgery (MIDCAB) using ultrasound-assisted blockade in erector spinae plane (ESP).

MATERIALS AND METHODS: A prospective, two-center, randomized study included 37 patients who underwent MIDCAB surgery. In group 1, before the induction of general anesthesia, an ESP block was performed; in group 2, the operation was performed only under general anesthesia.

RESULTS: The consumption of fentanyl for anesthesia differed in groups 1 (ESP block) and 2 (general anesthesia): 0.9 (0.8; 1.0) mg vs 3.0 (2.6; 3.2) mg (p <0.01). The norepinephrine dosage was higher in group 2 than in group 1: 0.18 (0.16; 0.22) mcg/kg/min vs 0.05 (0.04; 0.06) mcg/kg/min (p <0.01). Postoperatively, the pain score was lower in group 1 than in group 2, and no additional opioids were required during the first 3–4 h after extubation. Thereafter, no differences in pain scores were observed between the groups.

CONCLUSION: The use of an ESP block with a single injection of a local anesthetic is effective in reducing the total dosage of fentanyl used during surgery, dosage of norepinephrine, and mechanical ventilation and improve the quality of postoperative analgesia during MIDCAB.

关键词

combined anesthesia, regional anesthesia, ESP block, minimally invasive coronary bypass surgery, MIDCAB, multimodal anesthesia

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俄罗斯联邦, St. Petersburg

参考

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2. Fig. 2. Study scheme.Note. ESP — erector spine plane, ОА — general anesthesia.

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3. Fig. 2. Ultrasound picture of the musculoskeletal-ligamentous complex of the back.Note. TR — trapezius muscle, R — rhomboid muscle, ES — erector spine muscle, TP — transverse process, P — pleura, N — needle.

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4. Fig. 3. Maximum dosage of norepinephrine during surgery.Note (here and in Fig. 4, 5). ESP — erector spinae plane block, ОА — general anesthesia.

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5. Fig. 4. Fentanyl consumption per operation.

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6. Fig. 5. Duration of extended ventilation.

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