EFFICACY OF USG GUIDED SINGLE SHOT BILATERAL ERECTOR SPINAE PLANE BLOCK WITH DEXMEDETOMIDINE AS AN ADJUVANT TO ROPIVACAINE IN PATIENT UNDERGOING OFFPUMP CABG

Abstract

Introduction: Coronary artery bypass grafting (CABG) is a popular surgical procedure for coronary artery disease, but its popularity has declined due to alternative treatments. The erector spinae plane (ESP) block, a local anesthesia technique, is a promising alternative for pain management. The study evaluates the effectiveness of USG-guided ESP blocks with dexmedetomidine in off-pump CABG patients, aiming to improve pain management and reduce opioid consumption. Aims: The study evaluates the efficacy of bilateral single shot erector spinae plane block with dexmedetomidine as an adjuvant to ropivacaine in adult cardiac surgical patients. Methodology: A prospective, randomized controlled study at Krishna Institute of Medical Sciences in Karad, Maharashtra, aimed to detect an estimated difference in postoperative fentanyl consumption between patients undergoing cardiac surgery. The study involved 60 adult patients aged 18-60 years and elective cardiac surgical patients undergoing CABG (off pump). The study included a comprehensive hemogram, random blood sugar, blood urea, serum creatinine, electrocardiogram, chest Xray, and coagulation profile. Results: The study compared the age, ASA status, heights, weight, surgery duration, heart rates, SpO2 levels, MAP values, systolic blood pressure, DBP values, and VAS scores of ER and ERD treatment groups. Results showed no significant differences, suggesting comparable respiratory stability and oxygenation efficacy. The ER group reported lower pain levels at 2 hours, while the ERD group required rescue analgesia later. The most common adverse events were bradycardia, hypotension, and vomiting among both groups combined. Discussion: The study found that dexmedetomidine and ropivacaine combined effectively for pain management, but their advantages diminished over time, despite maintaining similar oxygen saturation levels and respiratory stability. Conclusion: The study showcases the efficacy of ultrasound-guided bilateral ESP with ropivacaine plus dexmed in cardiac surgical procedures, reducing rescue analgesia and opioid consumption.