Cardiothoracic & vascular anaesthesia
Combination of Serratus Anterior and Deep Parasternal Intercostal Plane Blocks versus Erector Spinae Plane Block for Acute Pain Management After Cardiac Surgery: A Randomized Controlled Trial
Authors' conclusion
In patients undergoing open-heart surgery through median sternotomy, bilateral ESPB provided more effective opioid-sparing analgesia compared to the combined DPIPB+SAPB technique, despite similar subjective pain scores and side effect profiles.
Study context
- Population
- Patients scheduled for elective on-pump cardiac surgery through median sternotomy
- Participants
- 60 patients
- Comparison
- Bilateral erector spinae plane block (ESPB) vs combined deep parasternal intercostal plane block (DPIPB) and serratus anterior plane block (SAPB)
- ESPBn = 30
- DPIPB+SAPBn = 30reference
- Primary endpoint
- Postoperative opioid consumption
- Follow-up
- First 24 hours
Methodological detailsprospective, assessor-blinded, single-centre
- Prospective
- Assessor-blinded
- Single-centre
Primary result
As reported in the abstract
Cumulative opioid consumption
P = 0.022
Secondary outcomes
Pain scores at sternotomy or drain sites, at rest and during coughing · any time point
- No significant differences (p > 0.05)
Rescue analgesic requirements
- No significant differences between the 2 groups (p > 0.05)
Safety
Opioid-related side effects
- No significant differences between the 2 groups (p > 0.05)
Original publication
Combination of Serratus Anterior and Deep Parasternal Intercostal Plane Blocks versus Erector Spinae Plane Block for Acute Pain Management After Cardiac Surgery: A Randomized Controlled Trial. J Cardiothorac Vasc Anesth. Published 6 August 2025. doi:10.
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