Erector spinae plane block for tricuspid valve surgery through mini-thoracotomy in patients with drug addiction

Objective. To evaluate the effectiveness of erector spinae plane block for tricuspid valve surgery through mini-thoracotomy in patients with drug addiction. Material and methods. A prospective single-center randomized trial included 20 patients after tricuspid valve surgery for infective endocarditis. Mean age was 31.5 [26; 37] years. There were 16 men and 4 women. Tricuspid valve replacement for endocarditis was performed in 4 patients, tricuspid valve excision due to endocarditis — in 16 patients. Cardiopulmonary bypass (93 [68; 124] min) was used in all cases. Patients were randomized into 2 groups: group 1 (control group) — standard anesthetic management with inhalation anesthetics, opioid analgesics and muscle relaxants; group 2 (study group) — additional erector spinae plane block with 0.5% ropivacaine 20 ml into fascial compartment of the appropriate muscle. The study included blockade and control of intraoperative and early postoperative parameters. Clinical parameters, VAS scores of pain after tracheal extubation, total intraoperative doses of fentanyl and the need for prolonged infusion of opioid analgesics in early postoperative period were recorded. Results. Erector spinae plane block excluded opioid analgesia from anesthetic management in patients with drug addiction. There were lower VAS scores of postoperative pain over 24 hours and less incidence of respiratory failure. Conclusion. Erector spinae plane block in anesthetic management of cardiac surgery through mini-access in patients with drug addiction can be considered as an effective method of non-opioid analgesia and postoperative management. Further research in this area is required.