Intravenous(IV) vs. Erector Spinae Plane Blocks in Cardiac Surgery

Erector Spinae Plane Block Clinical Trial

Official title: IV vs. Erector Spinae Plane Blocks-Cardiac Surgery

Status Completed

Clinical Trial Summary

Interfascial plane blocks have been developed for analgesia, among which the erector spinae plane (ESP) has gained popularity. The ESP block has been hypothesized to provide truncal analgesia by spread of local anesthetic into the paravertebral space. Recent studies have contested this idea showing unreliability in the spread of the local anesthetic into the paravertebral space.

Clinical Trial Description

Post-operative pain is a significant issue following open heart surgeries and poorly controlled pain can result in significant cardiorespiratory morbidity. Many patients suffer pain both at rest (49%) and on movement (62%) following open heart surgeries via sternotomy and adequate pain management requires closer re-assessment and treatment. The intensity of pain is noted to be higher in the first 48 hours post surgery and hence modalities to control pain may make the greatest difference in the first 2 days after surgery.

Enhanced recovery pathways utilizing multimodal analgesia have shown significant analgesic and opioid sparing benefit while minimizing ICU and length of hospital stays. Some multimodal regimens have also incorporated regional blocks but the optimal analgesic regimen remains elusive. The ESP block has been hypothesized to provide truncal anesthesia by spread of local anesthetic into the paravertebral space, but recent studies contest this idea. Bilateral paravertebral blocks can result in higher than acceptable levels of local anesthetic in both cardiac and non-cardiac surgical patients and this may be true following bilateral erector spinae plane (ESP) as well. Hence, the pharmacokinetic profile of administered local anesthetics is necessary given the lack of information about the local anesthetic systemic levels following bilateral ESP. ;

Related Conditions & MeSH terms

• Chronic Pain
• Erector Spinae Plane Block
• Pain Control
• Pain, Postoperative

• NCT number: NCT04995497
• Study type: Interventional
• Source: University of Iowa
• Status: Completed
• Phase: Phase 2
• Start date: August 15, 2021
• Completion date: April 30, 2023