Abstact
Introduction: Providing adequate analgesia during subcutaneous ICD
implantation can be a challenge. The use of regional techniques such as
erector spinae plane (ESP) block can provide both analgesia and
attenuate the risk of opioid use especially in high-risk patient
populations.
Methods: This was a single center, prospective study of patients
undergoing SICD implantation from February 2020 to February 2022.
Patients were older than 18 years of age and randomly assigned to
receive ESP block or traditional wound infiltration. The primary outcome
was the overall use of perioperative analgesic medications in the ESP
block versus the surgical wound infiltration group. Descriptive data are
reported as count, mean, or median, as appropriate. For group
comparisons, Fisher’s exact test was used for categorical variables; the
student t-test was used for normally distributed continuous variables,
and the Krustal-Wallis test was used for skewed continuous variables, as
appropriate.
Results: 24 patients were enrolled in the study. 11 patients received
only wound infiltration and 13 patients received left ESP block. A
significant reduction of intraoperative fentanyl use was observed in the
ESP block. The overall postoperative day zero fentanyl use was also
significantly decreased in the ESP group. The day to discharge was
shorter in the ESP block group.
Conclusion: This feasibility study showed that ESP block is both a safe
and effective technique and demonstrated a significant decrease in
intraoperative and postoperative opioid consumption that may be of
clinical benefit in high risk patients. Larger studies are needed to
further validate its use.