Cardiothoracic & vascular anaesthesia
Analgesic efficacy and safety of lidocaine administered by intravenous route vs erector spinae plane blocks following open heart surgery: An open-label, randomized clinical trial
Authors' conclusion
ESP blocks utilizing lidocaine did not demonstrate superior postoperative analgesia compared to intravenous lidocaine in patients undergoing elective primary cardiac surgery via midline sternotomy.
Study context
- Population
- Adults (18–80 years) undergoing primary single procedure elective cardiac surgery via midline sternotomy60 analysed
- Participants
- 70 adults
- Comparison
- Lidocaine via continuous bilateral erector spinae plane (ESP) block vs intravenous (IV) lidocaine infusion
- Primary endpoint
- Cumulative opioid consumption (oral MME) in the first 48 h postoperatively and pain scores (NRS) at 48 h
- Follow-up
- 48 h
Methodological detailsopen-label
- Open-label
Primary result
As reported in the abstract
ESP vs IVMD (95% CI)P value
Opioid consumption, first 48 hours
−12.43(−43.7 to 18.8)
P = 0.375Pain scores at 48 h
0.05(−1.7 to 1.8)
P = 0.878Secondary outcomes
Additional timepoints for pain and opioid consumption within 48 h; plasma lidocaine levels
- No significant differences in secondary outcomes
Safety
Events
| Outcome | ESP | IV |
|---|---|---|
| Plasma arterial lidocaine levels exceeding 5 μg/mL · 24 h | 2 | 4 |
Original publication
Analgesic efficacy and safety of lidocaine administered by intravenous route vs erector spinae plane blocks following open heart surgery: An open-label, randomized clinical trial. J Clin Anesth. Published 10 March 2026. doi:10.
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