The Effect of Bilateral Erector Spina Plane Block on Postoperative Pain in Adult Cardiac Surgery.
Postoperative Pain, Opioid Use
About this trial
This is an interventional prevention trial for Postoperative Pain
Eligibility Criteria
Inclusion Criteria:
- Male and / or female patients aged 18-65 will be included in the study.
- Normal left ventricular function (alternating one, two and three vessels).
- coronary artery patients scheduled for elective coronary artery surgery under cardiopulmonary bypass,
- Valvular diseases planned for elective valve replacement with normal left ventricular function, ASD (Atrial Septal Defect) cases for atrial septal defect closure, and patients without left ventricular dysfunction (E / F≥ 50-55%) elective valve + CABG will be included in the study.
Exclusion Criteria:
- Patients requiring acute coronary syndrome and emergency cardiovascular surgery,
- Patients who have had myocardial infarction within the past month
- Recurrent cardiovascular surgery
- Off-pump coronary artery bypass surgery (OPCAB)
- Patients with chronic inflammatory disease (rheumatoid arthritis, malignancy, psoriasis, etc.), autoimmune disease, immunocompromised patients
- Patients with chronic renal failure, liver disease, active infection
- Patients older than 80 years and smaller than 18 years
- Patients with coagulation disorders
Sites / Locations
- Kahramanmaras Sutcu Imam University Faculty of Medicine
- Yavuz Orak
Arms of the Study
Arm 1
Arm 2
Active Comparator
No Intervention
Group ESP
Group Control
While the patient is in a sitting position, A ultrasound probe covered with a sterile sheath will be placed approximately 2 cm to the right or left of the T 4-5 spinous process. After the T 4-5 transverse process and the erector spinae muscle above it are shown, a quincke-type needle will be inserted into the skin at an angle of approximately 30 degrees from cranial to caudal with the entrance made using the in-plane technique. When the transverse process is touched, the needle will be pulled out and a local anesthetic solution will be applied to the fascia beneath the erector spinae muscle. A 20 mL dose of 0.25% bupivacaine, which has been shown to spread both above and below the T 4-5 level, will be injected.The same procedure will be repeated on the contralateral side of the T5 spinous process and half of the remaining bupivacaine dose will be injected. The total volume of bupivacaine injected on both sides will be 20 mL.
No block will be made to the control group. After extubation, 1mg / kg tramadol will be applied routinely to both groups, and PCA (Patient Control Analgesia) and morphine consumption and VAS (visual analog scale) pain scores of both groups will be evaluated and recorded at the 1st, 4th, 12th and 24th hour. When VAS is 3, patients will be advised to press the PCA device.