343 posters, 5 videos, 2 audios, 18 topics, 33 sessions, 263 authors, 202 institutions

24th Annual Pain Medicine Meeting 2025

November 13-15, 2025| JW Marriott Austin, Austin, Texas

2198348

Intermittent Bolus vs. Continuous Infusion Erector Spinae Catheters for Median Sternotomy Incisions: A Randomized Controlled Trial

Preview of Intermittent Bolus vs. Continuous Infusion Erector Spinae Catheters for Median Sternotomy Incisions: A Randomized Controlled Trial

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Poster Presenter

aUSTIN MEADOWS

Authors

aUSTIN MEADOWS

Affiliations

Henry Ford Health

Part of Topic

Scientific Abstracts > Regional Anesthesia

Intermittent Bolus vs. Continuous Infusion Erector Spinae Catheters for Median Sternotomy Incisions: A Randomized Controlled Trial

Austin M. Meadows M.D., Carlos E. Guerra-Londono, M.D., Katherine Nowak, Ph.D., Franklin Dexter, M.D., Ph.D., FASA, and Patrick B. Forrest, M.D.

INTRODUCTION

• Uncontrolled pain can worsen postoperative outcomes in adults undergoing open-heart surgery.

• Erector spinae plane (ESP) analgesia via indwelling ESP catheters decreases postoperative opioid consumption.

• The optimal method of local anesthetic administration remains unknown.

•Hypothesis: The use of programmed intermittent boluses results in superior postoperative analgesia compared to continuous infusion of local anesthetics through ESP catheters after cardiac surgery.

METHODS

• Study: IRB-approved, Single-center, parallel-group, randomized, double-blind trial (NCT05642416).

• Population: Adults, open-heart surgery, midline sternotomy, scheduled ESP analgesia with 0.2% ropivacaine via ambIT® PIB-IL infusion pump (Avanos Medical, Inc, Alpharetta, GA).

• Intervention: Programmed intermittent bolus of 30mL Q3 hrs.

• Comparison: Continuous infusion at 10ml per hour.

• Primary Outcome: Mean postoperative opioid consumption at 72 hours in OMME.

• Secondary Outcomes: Postoperative pain, length of stay (ICU & hospital), quality of recovery, nausea, and constipation (indirectly).

RESULTS

• The intermittent bolus group had an estimated 1.08-fold greater OMME than the continuous infusion group (95% confidence interval 0.90 to 1.31, P = 0.40).

• The mean difference was 4.1 OMME larger per day for the intermittent bolus group (95% confidence interval -5.6 to +13.8 mg).

• There were no significant differences between groups in postoperative pain intensity, quality of recovery, & measures of nausea and constipation.

CONCLUSION

Programmed intermittent bolus dosing of ESP catheters for postoperative analgesia following open-heart surgery was not superior to continuous infusion to reduce early postoperative opioid consumption.

This study was funded by an investigator-initiated research grant from Avanos Medical, Inc.