Our Summary

This research paper is about a study on the benefits of a specific type of pain management technique known as single-shot erector spinae plane block (ESPB) on patients undergoing heart surgery via a procedure called sternotomy.

The researchers analyzed 10 other studies involving a total of 695 patients to see if the single-shot ESPB technique was better than the standard pain relief methods. They looked at various factors such as the level of pain experienced by the patient 4 and 12 hours after surgery, the length of time the patient needed to be on a ventilator, the total amount of opioid painkillers used after surgery, the duration of the hospital and intensive care unit stays, and the incidence of postoperative nausea and vomiting.

The results showed that the single-shot ESPB technique significantly reduced the pain score 4 hours after surgery, the time a patient needed to be on a ventilator, the total amount of opioid painkillers used after surgery, and the risk of postoperative nausea and vomiting. However, it did not significantly reduce the pain score 12 hours after surgery, the length of hospital and intensive care unit stays.

In simpler terms, the study suggests that this type of pain management technique is beneficial for patients undergoing heart surgery as it can reduce early postoperative pain, the need for strong painkillers, and the risk of postoperative nausea and vomiting. However, more studies are needed to confirm these results.

FAQs

  1. What is the effect of single-shot erector spinae plane block (ESPB) on pain after cardiac surgery via sternotomy?
  2. Does single-shot ESPB affect the length of hospital stay and ICU stay after cardiac surgery via sternotomy?
  3. How does single-shot ESPB impact postoperative opioid usage and incidence of nausea and vomiting after cardiac surgery via sternotomy?

Doctor’s Tip

A helpful tip a doctor might tell a patient about sternotomy is to consider discussing the option of a single-shot erector spinae plane block (ESPB) for improved pain management and faster recovery after the surgery. This technique has been shown to reduce pain levels, decrease the need for opioids, shorten the duration of mechanical ventilation, and lower the incidence of postoperative nausea and vomiting. It is important to consult with your healthcare provider to see if this option is suitable for your individual case.

Suitable For

Patients undergoing cardiac surgery via sternotomy are typically recommended for single-shot erector spinae plane block (ESPB) to help reduce pain, duration of mechanical ventilation, cumulative postoperative opioid usage, and incidence of postoperative nausea and vomiting (PONV). This intervention has been shown to improve near-term clinical outcomes in these patients. More randomized controlled trials are needed to further validate these findings.

Timeline

  • Before sternotomy:
  1. Patient undergoes pre-operative evaluation and preparation for cardiac surgery.
  2. Patient is informed about the procedure, risks, and benefits.
  3. Patient undergoes anesthesia induction and is positioned for surgery.
  4. Sternotomy is performed, and the chest is opened to access the heart.
  5. Surgery is performed on the heart or surrounding structures.
  6. Patient is closed up and transferred to the recovery room for monitoring.
  • After sternotomy:
  1. Patient experiences pain and discomfort at the surgical site.
  2. Patient may receive standard-of-care analgesia for pain management.
  3. Patient may be extubated and weaned off mechanical ventilation.
  4. Patient is monitored in the ICU for postoperative care.
  5. Single-shot erector spinae plane block (ESPB) is administered for pain management.
  6. Patient experiences reduced pain score at postoperative hour 4, reduced duration of mechanical ventilation, reduced opioid usage, and reduced incidence of postoperative nausea and vomiting.
  7. Patient may be discharged from the ICU and transferred to a regular hospital room.
  8. Patient continues to recover and undergoes rehabilitation before discharge from the hospital.

What to Ask Your Doctor

  1. How does single-shot erector spinae plane block (ESPB) compare to standard-of-care analgesia in terms of pain relief after cardiac surgery via sternotomy?
  2. What are the potential benefits of receiving a single-shot ESPB in terms of reducing pain at postoperative hours 4 and 12?
  3. How does single-shot ESPB impact the duration of mechanical ventilation after cardiac surgery via sternotomy?
  4. Can receiving a single-shot ESPB lead to a decrease in hospital length of stay and intensive care unit (ICU) length of stay?
  5. What is the effect of single-shot ESPB on cumulative postoperative opioid usage in patients undergoing cardiac surgery via sternotomy?
  6. What is the incidence of postoperative nausea and vomiting (PONV) in patients who receive a single-shot ESPB compared to standard-of-care analgesia?
  7. Are there any potential risks or side effects associated with receiving a single-shot ESPB after cardiac surgery via sternotomy?
  8. How does single-shot ESPB fit into the overall pain management plan for patients undergoing cardiac surgery via sternotomy?
  9. Are there any specific patient populations who may benefit more from receiving a single-shot ESPB after cardiac surgery via sternotomy?
  10. What further research is needed to better understand the impact of single-shot ESPB on clinical outcomes in patients undergoing cardiac surgery via sternotomy?

Reference

Authors: Greene JJ, Chao S, Tsui BCH. Journal: J Cardiothorac Vasc Anesth. 2024 Apr;38(4):964-973. doi: 10.1053/j.jvca.2023.12.014. Epub 2023 Dec 16. PMID: 38341301