Evaluation of the effect of preemptive erector spina plan block application on postoperative pain in patients undergoing coronary artery by- pass graft surgery

Objective: We aimed to evaluate the effect of preemptive erector spinal plane (ESP) block application on intraoperative and postoperative opioid consumption in coronary artery by-pass graft (CABG) operations. Methods: After the ethics committee and the written consent of patients was obtained,65 patients at risk of ASA III between the ages of 18-75 who underwent CABG surgery by planning elective surgery under general anesthesia in the operating room of the Bolu Abant Izzet Baysal University (BAIBU) Training and Research Hospital were invited to the study. 5 patients refused to participate in the study. 60 patients were divided into 2 groups by randomized, Group E (ESP) and Group K (Control), with 30 patients in each group. 10 patients were excluded from the study during the follow-up period. Before the induction of general anesthesia in Group E patients ESP block was performed at the T5 transverse process level in the prone position, under USG guidance. The block was considered successful when the sense of cold disappeared. In Group K, preoperative procedure was not applied to patients. All patients underwent off-pump CABG surgery under general anesthesia. After the operation, the patients were taken to the Intensive Care Unit (ICU) while being intubated. Extubations were performed within 4 hours. Intravenous (IV) Patent- Controlled Analgesia (PCA) was applied to all patients in Group E and Group K after extubation. All patients were followed up for 48 hours after extubation reguiding VAS (Visual Analogue Scale) value, analgesic consumption, possible side effects and patient satisfaction. Results: In this study, the data of 50 patients who met the criteria were examined. In Group E, VAS values at 30 minutes, 1st hour, 2nd hour, 4th hour, 8th hour, 12th hour and 16th hour after postoperative extubation were found as significantly lower than Group K (p <0,05). Tramadol consumption was significantly lower in Group E at 0-1 hours, 12-24 hours, and 12-24 hours. Amount of total consumption was also found significantly lower in Group E (p <0,05). Conclusions: It was found that preemptive ESP block application decreased the VAS value in the first 18 hours postoperatively and decreased intraoperative and postoperative opioid consumption.