Date of this Version
12-1-2023
Document Type
DNP Project
Abstract
Background: Cardiac surgery is associated with significant postoperative pain, traditionally managed with opioids and epidural techniques. The erector spinae (ESP) block, providing analgesia to the anterior, lateral, and posterior chest wall, is described as a simplistic safe alternative to the thoracic epidural (TEA) or paravertebral block (PVB) for cardiacpatients . The literature suggests that its minimal risk of vascular puncture, hypotension, or local anesthetic toxicity and superior postoperative pain scores enhance patient recovery after cardiac surgery.
This doctoral project aimed to answer the PICO question: In adult cardiac surgical patients, is the use of the erector spinae block, compared to the paravertebral block or thoracic epidural analgesia, effective in decreasing postoperative pain and complications?
Methods: The proposed project's primary approach is to engage anesthesia providers with an online educational intervention that emphasizes the advantages of the ESP block for cardiac surgery. The improvement in providerknowledge before and after the intervention was measured using pre- and post-assessment surveys. There will also be an evaluation of the ESP block's likelihood of use and recommendation for heart surgery.
Results: The educational intervention led to a general enhancement in provider knowledge. Overall, the probability of using and endorsing the ESP block increased.
Conclusion: Inadequate postoperative pain management is linked to increased morbidity and mortality. The impact ofenhanced recovery after surgery and fast-tracking protocols necessitates implementing effective multimodal techniques. The ESP block offers a cost-effective alternative for the cardiac surgery patient compared to the thoracic epidural and paravertebral block. The ESP block was found to have comparable pain control or better pain control with fewer adverse effects. Implementation of the ESP block as a multimodal analgesic strategy in the cardiac surgical patient can enhance recovery after cardiac surgery. Its favorable safety profile is a cost- effective alternative to the TEA and PVB.
Recommended Citation
Marcos, Camila A.; Diaz, Valerie J.; and Gattorno, Jordany, "Efficacy of Erector Spinae Block versus Paravertebral or Thoracic Epidural in Cardiac Surgery: An Evidence-Based Educational Module" (2023). Nicole Wertheim College of Nursing Student Projects. 237.
https://digitalcommons.fiu.edu/cnhs-studentprojects/237