Regional Anesthesia for Cardiothoracic Enhanced Recovery

Regional Anesthesia for Cardiothoracic Enhanced Recovery for Patients Undergoing Cardiac Surgery Via Sternotomy

The erector spinae plane block (ESPB) is a novel regional analgesic technique that provides pain relief with a peripheral nerve block catheter. The goal of this study is to see if bilateral ESPB catheters can improve clinical outcomes in patients undergoing cardiac surgery via sternotomy, such as decreasing the duration of postoperative mechanical ventilation, need for intravenous opioid medications, length of stay in the intensive care unit (ICU), and improving pain scores.

Inclusion Criteria:

• Give consent to participate in study
• planned sternotomy
• specific procedures: CABG (coronary artery bypass grafting) or AVR (aortic valve repair or replacement) or MVR (mitral valve repair or replacement) or combination of any of 2 of these
• Primary or first redo sternotomy

Exclusion Criteria:

• Participants who cannot give consent
• Patients who are clinically unstable or require urgent/emergent intervention
• more than1 prior sternotomy
• planned aortic arch procedures
• preoperative coagulopathy (INR >1.5, PTT >35) or ongoing anticoagulation (heparin infusion, therapeutic low molecular weight heparin, warfarin, dual antiplatelet therapy)
• Severe ventricular dysfunction (left or right ventricle)
• Symptomatic heart failure (systolic or diastolic)