The effect of ultrasound-guided bilateral single-shot erector spinae plane block on recovery after on-pump coronary bypass graft surgery: a randomized controlled study

Background
Fast-track and ultra-fast-track anesthesia techniques can be facilitated with opioid requirements’ reduction and multi-modal analgesia techniques that include the regional anesthesia techniques. The study aimed to assess the preoperative effect of single-shot bilateral ultrasound-guided erector spinae plane block (ESPB) on the extubation time and postoperative pain of patients undergoing on-pump CABG surgery.
Results
The ESPB group was statistically significant decreased regarding the extubation time, ICU length stay, intraoperative fentanyl, and postoperative morphine consumption than the control group ( < 0.0001 for all the previous measurement). The 1st time of rescue analgesia of the ESPB group was longer than the control group ( < 0.0001). The numerical rating score (NRS) after extubation of the ESPB group was lower at 2 and 4 h after extubation ( = ˂ 0.0001 and 0.0006 respectively) than the control group. The number of patients who required rescue analgesia after extubation was significantly decreased in the ESPB group in comparison to the control group, 2 and 4 h after extubation ( =  < 0.0001 and 0.004 respectively).
Conclusions
The preoperative single-shot ultrasound-guided ESPB in patients scheduled for on-pump CABG surgery shortened the extubation time and the length of ICU, decreased intraoperative fentanyl and postoperative morphine consumption and postoperative pain scores, and prolonged 1st time of rescue analgesia without significant effect on the incidence of complications, re-intubation, or mortality.
Trial registration
Approval was obtained from the Research Ethics Committee of the Faculty of Medicine (approval code of 33702/02/20) registered at February 2, 2020, and written informed consent was obtained from the patients. The trial was registered at 17 March 2020 in the Pan African Clinical Trial Registry with a unique identification number for the registry which is PACTR202003822626676.