Continuous Erector Spinae Plane (ESP) Block for Postoperative Analgesia after Minimally Invasive Mitral Valve Surgery

THERE IS an increasing trend toward the use of minimally invasive approaches in cardiac surgery. 1 Cuartas M.M. Javadikasgari H. Pfannmueller B. et al. Mitral valve repair: Robotic and other minimally invasive approaches. Prog Cardiovasc Dis. 2017; Google Scholar Many of these utilize a thoracotomy incision, which is associated with significant acute 2 Rodriguez-Aldrete D. Candiotti K.A. Janakiraman R. et al. Trends and new evidence in the management of acute and chronic post-thoracotomy pain - an overview of the literature from 2005 to 2015. J Cardiothorac Vasc Anesth. 2016; 30: 762-772 Abstract Full Text Full Text PDF PubMed Scopus (47) Google Scholar , 3 Walther T. Falk V. Metz S. et al. Pain and quality of life after minimally invasive versus conventional cardiac surgery. Ann Thorac Surg. 1999; 67: 1643-1647 Abstract Full Text Full Text PDF PubMed Scopus (199) Google Scholar and chronic pain. 4 Forero M. Adhikary S.D. Lopez H. et al. The erector spinae plane block: A novel analgesic technique in thoracic neuropathic pain. Reg Anesth Pain Med. 2016; 41: 621-627 Crossref PubMed Scopus (917) Google Scholar Regional anesthesia is commonly advocated as part of a multimodal analgesic strategy, but the first-line options of thoracic epidural analgesia and thoracic paravertebral block 2 Rodriguez-Aldrete D. Candiotti K.A. Janakiraman R. et al. Trends and new evidence in the management of acute and chronic post-thoracotomy pain - an overview of the literature from 2005 to 2015. J Cardiothorac Vasc Anesth. 2016; 30: 762-772 Abstract Full Text Full Text PDF PubMed Scopus (47) Google Scholar are not usually feasible in cardiac surgery, where perioperative anticoagulation and hemodynamic instability are commonplace. 2 Rodriguez-Aldrete D. Candiotti K.A. Janakiraman R. et al. Trends and new evidence in the management of acute and chronic post-thoracotomy pain - an overview of the literature from 2005 to 2015. J Cardiothorac Vasc Anesth. 2016; 30: 762-772 Abstract Full Text Full Text PDF PubMed Scopus (47) Google Scholar