Comparison between Two volumes in Bilateral Ultrasound Guided Erector Spinae Plan Block for Cardiac Surgery Analgesia | ||
| Al-Azhar International Medical Journal | ||
| Volume 2025, Issue 7, July 2025, Pages 298-303 PDF (401.56 K) | ||
| Document Type: Original Article | ||
| DOI: https://doi.org/10.21608/aimj.2025.446676 | ||
| Authors | ||
| Mahmoud Noor El-deen Abd Elsattar* 1; Wael Mohamed El Mahdi2; Elsayed Ahmed Elfiky3 | ||
| 1MSc, Anesthesia, Intensive Care and Pain Management, Faculty of Medicine, Al-Azhar University, Cairo, Egypt | ||
| 2Lecturer of Anesthesia, Intensive Care and Pain Management, Faculty of Medicine, Al-Azhar University, Cairo, Egypt | ||
| 3Professor of Anesthesia, Intensive Care and Pain Management, Faculty of Medicine, Al-Azhar University, Cairo, Egypt | ||
| Abstract | ||
| Background: If the postoperative pain from open heart surgery is not effectively managed, it can be quite severe. Surgical incisions, sternotomies, drains, thoracic back discomfort, distension of the costotransverse and costovertebral joints, and other postoperative complications can lead to severe pain following cardiac surgery. Aim and objectives: This study aimed to evaluate the efficacy of bupivacaine and lidocaine at varying doses for sternotomy pain relief using an ultrasound-guided erector spinae plane block (ESPB. Subjects and methods: The Al-Azhar University Hospitals carried out this prospective, single-blind, controlled, randomized study after receiving approval from the relevant institutional and departmental ethical committees. Sixty patients were prepared for open cardiac surgery using a midline sternotomy after receiving their informed consent. Results: A highly statistically significant (P<0.001) difference between the studied groups regarding intraoperative MAP in group I, where there is a decrease in MAP compared to group II of low volume after 30 minutes. 60min .120 min. Highly statistically significant (P<0.001) increase in intraoperative pulse in group I, where the pulse is less than that of group II, with 20 a total volume of local anesthetic. Conclusion: Higher volume (40ml) of local anesthetic in the ESPB provides more stable hemodynamics, including reduced heart rate variability and lower mean arterial pressure fluctuations, both intraoperatively and postoperatively. There was a correlation between the bigger volume block and improved pain control; this was seen by lower VAS scores and a delayed requirement for rescue analgesia as compared to the 20 ml block. | ||
| Keywords | ||
| Cardiac surgery analgesia; Bilateral ultrasound; ESPB | ||
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