Comparing Different Regional Blocks for Analgesia After Off-pump Cardiac Surgery

Analgesic Effects of Erector Spinae Plane Block Versus Superficial Parasternal Intercostal Plane Block Combined With Rectus Sheath Block After Off Pump Cardiac Surgery: A Randomised Trial

This study aims to compare the analgesic effects of erector spinae plane block versus Superficial Parasternal Intercostal Plane Block block along with rectus sheath block after off-pump cardiac surgery

General anaesthesia will be used for all patients. induction by midazolam 0.05-0.1 mg/kg, fentanyl 2-5 µ/kg, propofol 1-2 mg/kg, and atracurium 0.5 mg/kg for intubation. Maintenance by sevoflurane in oxygen-air mixture. regional blocks will be used after the induction of anaesthesia. Intraoperative analgesia will be maintained by fentanyl infusion 1-2 µ/kg/h while morphine sulphate 2.5-5mg will be used as rescue analgesia when pain score>4 beside acetaminophen 1000 mg /6 hours

Inclusion Criteria:

• American Society of anaesthesiologists physical status classification II-III
• Elective off-pump cardiac surgery

Exclusion Criteria:

• Cognitive impairment
• Allergy to local anaesthetics
• Renal and/or hepatic dysfunction
• Ejection fraction< 45%