Comparing erector spinae plane block with serratus anterior plane block for Coronary Bypass Graft Surgery

TITLE - Comparingerector spinae plane block with serratus anterior plane block for CoronaryBypass Graft Surgery. 

Background - Coronaryartery bypass grafting surgery is done in those patients who are havingmultiple blockages in the coronary arteries or in those patients angioplasty isnot possible. ForCABG thoracotomy has to be performed which causes significant pain intra aswell as post operatively. Erector spinae plane (ESP) block and serratus anterior plane (SAP) blockpromise effective thoracic analgesia compared with systemically administeredopioids. Needs to be compared in terms ofreduction in the opioids requirement during the surgery plus quality ofrecovery and overall morbidity after thoracic surgery.

Aim-  To compare the reduction ofthe opioids and to assess the quality of recovery and morbidity between ESB ( Erector spinae planeblock) and SAP (Serratus anterior plane)block

primary Objectives - Toassess the intra and post operative opioids requirement in erector spinae planeblock versus serratus anterior plane block in patients undergoing CABG.

Secondary Objectives - Toassess post-op complication using comprehensive complication index calculator and To assess qualityof recovery as per QoR-15 Scale after CABG in ESP AND SAP block patients.

Selection criteria - InclusionCriteria- 1. Elective Cardiac Surgeries UndergoingGeneral Anaesthesia.2: Age Between 18 To 80 3:Asa Grade 1 To 3 ExclusionCriteria- 1: Patient Refused To Give Consent ForStudy. 2: Patient Having Infections At BlockSite. 3: Contraindication to RegionalAnesthesia – preexisting coagulopathy, known local anesthetic sensitivity etc. 4: History Of Opiate Abuse 5: Pre- Existing Chronic Pain OrCognitive Dysfunction.

Materials Metods - •Studydesign - prospective randomized, observational study â€¢Duration-  4 to 8 months.

•Studygroups – a) ESP – erector spinae plane block. b) SAP – serratus anterior planeblock

•Levobupivacaine0.25% 20ml on each side given in both the blocks.

•Opioidsrequirement during the surgery and in the post op period will be noted as per haemodynamicparameters

•Qualityof recovery will be assessed using the quality of recovery-15 (qor-15) scale at24 h postoperatively.

•Consent- Informed consent will be obtained prior to surgery.

•Group size - calculated using power analysis based on a previous study report.

sample size - InDylan T. Finnerty et al in 2020.primaryoutcome was the QoR-15 score at 24 h postoperatively. The established minimumclinically important difference in QoR-15 is 8.0, and  SD ofQoR-15 scores after major surgery is in the order of 16 (range of QoRscore is 1–150).Therefore,assuming Type I error=0.05 and Type II error=0.2 (80% power to detect thisdifference), and using Power method  -Comparison of two means. Minimumestimated sample size was 82 (41 in each group), we will therefore include 90patients (45 per group) to in accordance to the pre-specified selectioncriteria.