Efficacy of Erector Spinae Plane Block Analgesia After Off Pump Cardiac Surgery

Efficacy of Erector Spinae Plane Block on Postoperative Analgesia and Recovery After Off Pump Cardiac Surgery: A Randomised Trial

In this study the investigators will investigate the efficacy of ESPB as a part of Enhanced recovery after surgery on postoperative analgesia and recovery criteria after off pump cardiac surgery.

General anaesthesia will be induced by 0.05 mg/kg midazolam, 3 µg/kg fentanyl, 1-2mg/kg propofol, and 0.5mg/kg of Atracurium. After induction, bilateral erector spinae plane block will be performed in the block group. Intraoperative analgesia will be achieved by fentanyl boluses of 0.5-to-1 µg/kg titrated according to haemodynamic parameters. Postoperative analgesia will be managed by paracetamol 1000 mg /6hours and morphine 1-2mg boluses when pain score ≥4 1 to 2 mg to be repeated every 5 minutes if needed.

Inclusion Criteria:

• age 18-70 years
• ejection fraction of > 45%
• undergoing elective off-pump cardiopulmonary bypass surgery

Exclusion Criteria:

• vertebral anomalies
• intra-aortic balloon pump in the preoperative period
• acute myocardial infarction
• local infection at the site of block
• allergy to the local anesthetic used
• morbid obesity, psychiatric disorders, neurologic deficits, alcohol and chronic opioid abuse, and patients with bleeding diathesis.