Date of this Version


Document Type

DNP Project





Background: Regional anesthesia has been at the forefront of opioid-sparing anesthesia. It has been proven time and again to be an effective method of safely and effectively controlling pain throughout the surgical process. Cardiac surgery presents its challenges to performing regional techniques due to the excessive amount of anticoagulation required to perform this type of surgery. The thoracic erector spinae plane block is a promising technique that has been shown to provide adequate pain control and is a safe alternative in patients who are anticoagulated compared to other regional techniques.

Objectives: The purpose of this study is to increase anesthesia provider knowledge on the value of the use of the ESP block for cardiac surgery. A literature review including primary research studies addresses the PICO question: “In anticoagulated patients undergoing general anesthesia for cardiac surgery, are erector spinae plane blocks when compared to thoracic epidurals, thoracic paravertebral blocks, and traditional methods safer to use while providing adequate perioperative analgesia?” The literature review is utilized to deliver the educational structure to increase provider knowledge. The objective is to increase provider awareness to improve patient outcomes and satisfaction related to cardiac surgery.

Methodology: The primary methodology of the proposed project is to administer an online educational intervention to providers which focuses on the benefits of the ESP block for cardiac surgery. Pre- and post-assessment surveys will be used to measure the improvement of provider knowledge before and after the intervention. The likelihood of use and recommendation of the ESP block for cardiac surgery will also be assessed.

Results: There was an overall improvement in provider knowledge following the educational intervention. The likelihood of utilizing and recommending the ESP block improved overall as well.

Conclusions: The evidence shows that the thoracic ESP block is a promising safe and effective tool for patients undergoing cardiac surgery via sternotomy or thoracotomy compared to the thoracic epidural, thoracic paravertebral block, and traditional methods. More research must be conducted via randomized controlled trials to ensure its safety and effectiveness.



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