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Research Paper | Anaesthesiology | India | Volume 13 Issue 5, May 2024 | Popularity: 6.3 / 10

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Comparison of Continuous Thoracic Epidural Analgesia (TEA) With Continuous Bilateral Erector Spinae Plane (ESP) Block for Perioperative Pain Management in Cardiac Surgery: A Prospective Randomized Controlled Trial (RCT)

Salman Mulla, Bindiya Gautam, Fayaz M Sultan, Manjula Sarkar, Vikram Vardhan

Abstract: Pain management in cardiac surgery is critical as sternotomy, sternal retraction, IMA harvesting, and chest tube insertions induce moderate-to-severe heart discomfort. Untreated pain produces hemodynamic abnormalities, systemic issues, and muscle weakness. The ultrasound guided erector spinae plane (ESP) block is a novel technique for thoracic nerve discomfort, fractured ribs, and mastectomy procedures. In this prospective, randomised clinical investigation, we have compared continuous thoracic epidural analgesia (TEA) and bilateral erector spinae plane (ESP) block for pain management in cardiac surgery. 40 cardiac surgery patients who met eligibility criteria were randomised to Group A-TEA or Group B-ESP block. Participants' demographics were well-documented. Both groups recorded the primary result on a visual analogue scale during repose post-extubation. Secondary outcomes included incentive spirometry, complications, and rescue analgesia. Visual Analogue Scoring was done at 0, 3, 6, 12, and 24 hour time points for both groups. According to VAS, Erector spinae plane block is more effective than thoracic epidural analgesia. Group B?s mean VAS score was lower than GroupA's. Timepoints eliminated Group B's pain score. Peak inspiratory spirometry of both groups at 0, 3, 6, 12, and 24 hour was also carried out and revealed that the group B exhibited higher peak inspiratory flow and lung capacity than group A.In comparison to other methods, the ESP block has a lot of advantages due to its efficiency, safety, and dependability. Blocking the ESPs is a analgesic option for patients having elective, urgent, or emergency heart surgery or who have sustained chest trauma.

Keywords: Epidural analgesia, erector spinae block, pain management in cardiac surgery, visual analogue score, peak inspiratory spirometry

Edition: Volume 13 Issue 5, May 2024

Pages: 22 - 26

DOI: https://www.doi.org/10.21275/SR24428183117

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