Efficacy And Safety of bilateral erector spinae block versus conventional analgesic method for postoperative analgesia in cardiac surgery patients

The postoperative pain after cardiac surgeries is severe and causes significant patient discomfort, delayed recovery, and at times prolonged hospital stay. The multifactorial pain could be due to reasons like tissue damage, sternotomy, the presence of intercostal drains, rib fractures, and extensive retraction of the thoracic cage. The American Society of Anaesthesiologist task force on the management for acute postoperative pain, recommend the use of multimodal conventional techniques for pain management. These include regional analgesia, intravenous (IV), and oral analgesics. Opioids, paracetamol, and nonsteroidal anti-inflammatory drugs have been administered as parenteral analgesics. Opioids can cause nausea, vomiting, pruritus, and respiratory depression when they are used solely for analgesia. Regional anaesthesia techniques like thoracic epidural analgesia and paravertebral blocks are excellent options but are usually not popular due to systemic heparinization during cardiovascular surgeries which may lead to hematoma formation. In the last few years, several chest wall blocks have been described and investigated for various thoracic surgeries including cardiac surgeries. Ultrasound guided (USG) erector spinae plane (ESP) block is recently introduced technique for regional analgesia in thoracic neuropathic pain, rib fractures, and breast surgeries. We are performing this study to compare efficacy of convention al method of analgesia with ultrasound guided bilateral erector spinae block for postoperative pain management in cardiac surgical patients.