In a recent randomized controlled trial undertaken by the researchers of Polland, it has been found that the addition of PECS (pectoralis nerve) blocks to ESP (erector spinae plane) block reduces the pain intensity along with the need for oxycodone and improves patient satisfaction with effective pain control after mitral/tricuspid valve repair via mini-thoracotomy. It also reduced the patients stay at the hospital after the surgery.

This prospective double-blinded study carried out in a tertiary hospital included 30 patients who have undergone mitral/tricuspid valve repair via mini-thoracotomy. The study population was randomized in 1:1 manner to ESP:PECS+ESP. In both groups, a single-shot, ultrasound-guided ESP block was given just additional PECS blocks were given to the patients of ESP+PECS group.

After mandatory extubation of each patient 2 h from the end of the surgery the pain was controlled via PCA pump with oxycodone. The primary outcome of the study was the assessment of total oxycodone consumption via PCA during the first postoperative day and the secondary outcome was comparing patients’ subjective pain intensity by using VAS.

It was found that less oxycodone via PCA pump was consumed by the patients of ESP + PECS group and this group patients experienced lesser pain intensity. Moreover, ESP+ PECS offered better patient satisfaction with pain management. Thus, with good clinical and patient-related outcomes in pain management after cardiac surgery, the ESP and PECS combination can be considered as an effective approach for the same.