• J. Cardiothorac. Vasc. Anesth. · Jul 2021

    Observational Study

    Erector Spinae Regional Anesthesia for Robotic Coronary Artery Bypass Surgery Is Not Associated With Reduced Postoperative Opioid Use: A Retrospective Observational Study.

    • Vanessa Moll, Ceressa T Ward, Craig S Jabaley, Vikas N O'Reilly-Shah, David W Boorman, Anne Marie McKenzie-Brown, Michael E Halkos, Amit Prabhakar, Laura R Pyronneau, and Peter C Schmidt.
    • Department of Anesthesiology, Emory University School of Medicine, Atlanta, GA; Institute for Anesthesiology, University Hospital Zurich, Zurich, Switzerland. Electronic address: Vanessa.moll@usz.ch.
    • J. Cardiothorac. Vasc. Anesth. 2021 Jul 1; 35 (7): 2034-2042.

    ObjectiveRegional anesthesia techniques are gaining traction in cardiac surgery. The aim of this study was to compare the analgesic efficacy of erector spinae plane block catheters (ESPBC), serratus anterior plane block catheters (SAPBC), and paravertebral single-shot block (PVB) versus no block after robotic minimally invasive direct coronary artery bypass (MIDCAB).DesignThis was a retrospective observational study of routinely recorded data.SettingThe study was performed at a single healthcare system.ParticipantsAll patients underwent robotic MIDCAB.InterventionData were analyzed from 346 patients during a 53-month period. The clinical data warehouse was queried for all robotic MIDCAB surgeries. Variables abstracted included type of nerve block, age, sex, use of adjuncts, Society of Thoracic Surgeons predicted short length of stay (PSLOS), total opioid consumption during the 72 hours after surgery, and postoperative hospital length of stay (LOS). The primary outcome was total oral morphine milligram equivalents (MME) consumed during the first 72 hours after surgery. The secondary outcome was hospital LOS.Measurements And Main ResultsIn a model adjusting for PSLOS, the authors did not observe an association between ESPBC and the reduction of total administered oral MME within 72 hours after surgery. There was no significant difference in MME when comparing patients who received PVB to patients with ESPBC. Older age and female sex were associated with significantly lower MME. Patients who received ESPBC had a significantly shorter hospital LOS than patients with SAPBC.ConclusionsThese findings suggested that postoperative pain after MIDCAB surgery might not be completely covered by ESPBC. Prospective studies are needed to further elucidate the value of this technique for robotic MIDCAB.Copyright © 2020 Elsevier Inc. All rights reserved.

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