• Islam Mohamed Elbardan, Elsayed Mohamed Abdelkarime, Hassan Saeed Elhoshy, Amr Hashem Mohamed, Dalia Ahmed ElHefny, and Ahmed Abd Bedewy.
• Department of Anesthesia and Surgical Intensive Care, Alexandria Faculty of Medicine, Alexandria, Egypt. Electronic address: Islam.elbardan@Alexmed.edu.eg.
• J. Cardiothorac. Vasc. Anesth. 2024 Mar 1; 38 (3): 691700691-700.

ObjectivesThis study aimed to investigate and compare the effects of the pectointercostal fascial plane block (PIFPB) and the erector spinae plane block (ESPB) on enhancing the recovery of patients who undergo cardiac surgery.DesignA randomized, controlled, double-blinded study.SettingThe operating rooms and intensive care units of university hospitals.ParticipantsOne hundred patients who were American Society of Anesthesiologists class II to III aged 18-to-70 years scheduled for elective cardiac surgery.InterventionsPatients were randomly assigned to undergo either ultrasound-guided bilateral PIFPB or ESPB.Measurements And Main ResultsPatients shared comparable baseline characteristics. Time to extubation, the primary outcome, did not demonstrate a statistically significant difference between the groups, with median (95% confidence interval) values of 115 (90-120) minutes and 110 (100-120) minutes, respectively (p = 0.875). The ESPB group had a statistically significant reduced pain score postoperatively. The median (IQR) values of postoperative fentanyl consumption were statistically significantly lower in the ESPB group than in the PIFPB group (p < 0.001): 4 (4-5) versus 9 (9-11) µg/kg, respectively. In the ESPB group, the first analgesia request was given 4 hours later than in the PIFPB group (p < 0.001). Additionally, 12 (24%) patients in the PIFPB group reported nonsternal wound chest pain, compared with none in the ESPB group. The median intensive care unit length of stay for both groups was 3 days (p = 0.428).ConclusionsErector spinae plane block and PIFPB were found to equally affect recovery after cardiac surgery, with comparable extubation times and intensive care unit length of stay.Copyright © 2023 Elsevier Inc. All rights reserved.

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