Evaluation of erector spinae plane block in cardiac surgery patients in terms of acute and chronic pain scores.

OBJECTIVE: Pain after cardiac surgery is a frequently encountered morbidity associated with poor quality of life and postoperative recovery. There have been several regional anesthesia modalities for this purpose. We aimed to investigate acute and chronic postoperative analgesic effects of erector spinae plane block (ESPB) after cardiac surgery. PATIENTS AND METHODS: We retrospectively evaluated patients who underwent cardiac surgery between December 2019 and December 2020. According to regional anesthesia management, there were two groups: ESPB and control groups. Patient demographic data, surgical outcomes, and Numerical Rating Scale (NRS) and Prince Henry Hospital Pain Scores (PHHPS) were recorded. RESULTS: Patients in the ESPB group were significantly younger than those in the control group (p=0.023). The duration of surgery was significantly shorter in the ESPB group (p=0.009). Patients in the ESPB group had significantly lower NRS and PHHPS pain scores assessed at the 48th hour after extubation (p=0.001 for both cases) and three months after discharge (p<0.001 and p=0.025, respectively). Significance remained after adjustment for age (p=0.029 and p<0.001, respectively) and duration of surgery (p=0.003 and p=0.041, respectively). CONCLUSIONS: ESPB might benefit patients with cardiac surgery by reducing acute and chronic postoperative pain.

The effect of intrathecal sufentanil preconditioning against myocardial ischemia-reperfusion injury.

OBJECTIVES: We aimed to investigate the cardioprotective effect and hemodynamic response of intrathecally administered sufentanil on myocardial IR injury. BACKGROUND: Sufentanil, mu opioid receptor agonist, intravenously administered during clinical and experimental studies, has been shown to have a cardioprotective effect on myocardial ischemia-reperfusion injury. METHODS: Thirty-two New Zealand type rabbits, which were anesthetized, were divided into four equal groups: sham, ischemia-reperfusion, sufentanil and ischemia-reperfusion+sufentanil. Sufentanil was administered intrathecally prior to ischemia. Hemodynamic parameters were monitored by electrocardiography and invasive arterial blood pressure measurements. In the ischemia-reperfusion groups, the degree of myocardial infarct was determined as the ratio of ischemic region to the risk area by a 1 % 2,3,5-triphenyl tetrazolium chloride staining. RESULTS: The mean infarct size in the ischemia-reperfusion group was 47.5 ± 7.0 %, whereas that of the ischemia-reperfusion+sufentanil group was found to be 34.2 ± 4.7 %, indicating a statistically significant difference (p = 0.002). The heart rate was different between the ischemia-reperfusion and the sufentanil groups for baseline measurement and between the ischemia-reperfusion and the ischemia-reperfusion+sufentanil groups at the 120th minutes measurement (p < 0.05). CONCLUSION: Intrathecal sufentanil appears to have a cardioprotective effect against myocardial ischemia--reperfusion injury in the experimental rabbit model (Tab. 1, Fig. 2, Ref. 19).