Ultrasound-Guided Serratus and Transversus Thoracic Muscle Plane Block Vs. Erector Spinae Plane Block for Acute Poststernotomy Pain

Comparison of Ultrasound-Guided Serratus Anterior and Transversus Thoracic Muscle Plane Block Combination Versus Erector Spinae Plane Block for Acute Poststernotomy Pain Management After Cardiac Surgery

Poststernotomy pain represents a complication that can arise following cardiac surgery. Inadequately managed pain has been linked to various adverse outcomes, including myocardial ischemia, cardiac arrhythmias, heightened coagulation tendencies, pulmonary complications, and elevated incidences of delirium and wound infections.

The Erector Spinae Plane (ESP) block, Serratus Anterior Plane (SAP) block, and Transverse Thoracic Muscle Plane (TTMP) block are demonstrated as effective regional anesthesia techniques for sternotomy pain. While these blocks differ in ease of application and efficacy, the optimal analgesic approach for cardiac surgery remains unclear. The aim of this study is to compare the analgesic efficacy of ultrasound-guided SAP and TTMP blocks combination versus ESP block administered alone in patients undergoing open heart surgery.

Inclusion Criteria:

• Cardiac Surgery with median sternotomy (valvular and coronary surgeries)

Exclusion Criteria:

• Minimal invasive cardiac surgeries
• Revision surgeries (during postoperative 48 hours)
• Redo cardiac surgeries
• Any contraindications for regional anesthesia technique (any allergies for local anesthetics)
• Preoperative chronic opioid usage