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- Title
Ultraschallgesteuerte, kontinuierliche thorakale „Erector Spinae Plane“-Blockade bei anterolateralen Thorakotomien in der Herzchirurgie: Eine retrospektive, patienten-gepaarte Vorher-Nachher-Pilot-Vergleichsstudie Clinical Anaesthesia.
- Authors
Flo Forner, A.; Kaplenkov, A.; Sgouropoulou, S.; Friedrich, L.; Zakhary, W. Z. A.; Ender, J.; Meineri, M.
- Abstract
Background The concept of Enhanced recovery after cardiac surgery concept includes multimodal opioid sparing therapies. erector spinae block (ESB) constitutes a safe alternative to reduce postoperative opioid consumption in cardiac surgery. The objective of this study was to compare the postoperative opioid consumption and the incidence of moderate-to-severe acute post-operative pain (APP) in patients receiving a continuous ESB compared to a standard opioid-based pain treatment. Methods We conducted a 1:1 patient-matched, retrospective observational, before-after pilot study in a University-affiliated Cardiac Center from January 2020 to October 2021 in adult patients undergoing cardiac surgery including thoracotomy with a fast track protocol. Pain medication and pain scores from extubation until hospital discharge were compared between 100 patients who received continuous ESB (ESB group) (25 t 30 ml 0.375 % ropivacaine bolus followed by 0.2 % ropivacaine 8/10 ml/h infusion (4/5 ml/20 min bolus on demand) until removal of chest tubes) and a historical group with the same surgical approach who was managed with a standard multimodal opioid-based postoperative pain regime (control group). Results The postoperative opioid requirement during the entire hospital stay was significantly higher in control group compared to ESB group. The median cumulative dose of IV. piritramide was 37 mg (22-53) vs. 0 mg (0-14), (p < 0.001) and PO. oxycodone 50 mg (40-80) vs. 20 mg (0-60), (p < 0.001). There was no difference in the incidence of moderate-to-severe APP between groups at any time point. Conclusion The use of continuous ESB in our cohort of patients reduced postoperative opioid consumption. No difference in the incidence of APP was found between groups.
- Subjects
GERMANY; PAIN measurement; THORACOTOMY; ERECTOR spinae muscles; SURGERY; PATIENTS; ROPIVACAINE; POSTOPERATIVE pain; PILOT projects; SCIENTIFIC observation; PIPERIDINE; RETROSPECTIVE studies; SPINAL infusions; MEDICAL device removal; OXYCODONE; DESCRIPTIVE statistics; ENHANCED recovery after surgery protocol; CONTROL groups; PRE-tests &; post-tests; OPIOID analgesics; MEDICAL records; ACQUISITION of data; COMPARATIVE studies; EXTUBATION; CHEST tubes; CARDIAC surgery; NERVE block
- Publication
Anaesthesiologie & Intensivmedizin, 2024, Vol 65, p104
- ISSN
0170-5334
- Publication type
Article
- DOI
10.19224/ai2024.104