In this study the investigators will investigate the efficacy of ESPB as a part of Enhanced recovery after surgery on postoperative analgesia and recovery criteria after off pump cardiac surgery.
General anaesthesia will be induced by 0.05 mg/kg midazolam, 3 µg/kg fentanyl, 1-2mg/kg propofol, and 0.5mg/kg of Atracurium. After induction, bilateral erector spinae plane block will be performed in the block group. Intraoperative analgesia will be achieved by fentanyl boluses of 0.5-to-1 µg/kg titrated according to haemodynamic parameters. Postoperative analgesia will be managed by paracetamol 1000 mg /6hours and morphine 1-2mg boluses when pain score ≥4 1 to 2 mg to be repeated every 5 minutes if needed.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
OTHER
Masking
NONE
Enrollment
50
After induction, the patients will be administered bilateral Erector spinae block with 20 ml of 0.25 % bupivacaine
fentanyl boluses of 0.5-to-1 µg/kg titrated according to haemodynamic parameters.
Menoufia university
Cairo, Shibin Elkom, Egypt
Total intraoperative and postoperative opioid consumption
Microgram and mg
Time frame: 48 hours
pain intensity at rest and movement
numerical rating score from zero to ten ( 0=no pain, 10 =severe pain )
Time frame: 48 hours
time to first rescue analgesia
minutes
Time frame: 24hous
Duration of mechanical ventilation
hours
Time frame: 24 hours
time to extubation
min
Time frame: 24hours
time to ambulation
hours
Time frame: 24hours
time to oral intake
hours
Time frame: 48 hours
time of chest drain removal
hours
Time frame: 5 days
time of intensive care unit stay
hours
Time frame: one week
The heart rate
Beats per minutes
Time frame: 48 hours
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mean arterial blood pressure
mmHg
Time frame: 48 hours