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.

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