Fascial plane blocks reduce opioid intake in cardiac surgery patients: BMC

The primary outcome was opioid use within 24 hours of surgery. Secondary outcomes included pain after extubation at 12 and 24 hours, postoperative nausea and vomiting, time to extubation, time to ICU discharge, and length of hospital stay.

The key highlights of the study were:

A total of 15 studies with 849 patients were included.

Regional anesthetic techniques included pectoral-intercostal fascia block, transverse thoracic muscle plane block, erector spinae plane (ESP) and mammary nerve block I.

All regional anesthetic techniques significantly reduced opioid consumption at 2 hours postoperatively, expressed as morphine milligram equivalent (MME). ESP blockade was the most effective treatment (-22.93 MME [-34.29; -11.56]).

In conclusion, fascial plane blocks were better than placebo in evaluating 24-hour MMEs. However, due to the paucity of studies available in the literature, it remains difficult to determine which is better. More randomized controlled trials are needed to determine the efficacy of regional anesthetics.

Reference:

Dost, B., De Cassai, A., Balzani, E., Tulgar, S., & Ahiskalioglu, A. (2022). Effects of ultrasound-guided regional anesthesia in cardiac surgery: a systematic review and network meta-analysis. BMC Anesthesiology, 22(1), 409. https://doi.org/10.1186/s12871-022-01952-7