Chronic postsurgical pain (CPSP) remains an important challenge after cardiac surgery. Although attention in the immediate postoperative period naturally focuses on hemodynamic stability, respiratory recovery, and acute pain control, pain can persist long after the sternotomy has healed. Previous research suggests that CPSP affects approximately 30% of patients 3 months after cardiac surgery and around 15% at 12 months. Beyond discomfort, persistent pain can interfere with sleep, movement, coughing and deep breathing, emotional well-being, and overall quality of life. One proposed strategy for reducing this burden is better control of acute postoperative pain. Acute pain is a recognized risk factor for CPSP, making effective perioperative analgesia a potential opportunity to interrupt the transition from acute to chronic pain. The erector spinae plane (ESP) block has become an increasingly used component of multimodal analgesia for cardiac surgery and can reduce acute pain and opioid requirements. But does better pain control during the first postoperative hours translate into less pain months later? Dost and colleagues addressed this question in a prospective randomized controlled trial published in Regional Anesthesia & Pain Medicine. They compared bilateral ESP block with standard care in patients undergoing elective cardiac surgery through median sternotomy.  Study objective and methods The investigators aimed to determine whether a single-shot bilateral ESP block could reduce the development and severity of CPSP following cardiac surgery, with the primary hypothesis that Brief Pain Inventory (BPI) scores at 3 months would differ between patients receiving an ESP block and those receiving standard care. This prospective, randomized, controlled trial was conducted at a tertiary university hospital. Patients were adults aged 18–80 years with ASA physical status II–III undergoing elective on-pump open cardiac surgery through a full median sternotomy. Sixty-seven patients were randomized, and 63 were ultimately included in the analysis: 31 in the ESP block group […]

When the August Daily Question rankings closed in the NYSORA Nerve Blocks App, one name was sitting at the top: Dr. Christophe Pericard. Naturally, we wanted to know more about the clinician behind the score. Christophe is an anesthesiologist at a university hospital in Strasbourg, France, working primarily in digestive surgery. During night shifts, however, his cases can take him across many different surgical specialties. And here is what made his result particularly interesting: regional anesthesia is not something he performs every day. For Christophe, that makes having a reliable way to revisit less familiar techniques particularly useful. Sometimes he opens the app simply to refresh his knowledge. Other times, there is a patient in front of him and a block he has not performed recently. When a familiar block becomes less familiar Christophe first discovered NYSORA several years ago while looking online for regional anesthesia information. “I discovered the NYSORA Nerve Blocks App a few years ago while searching online for information on regional anesthesia, which I don’t perform every day. I came across the NYSORA website, which naturally led me to the app.” Since then, the app has become a reference he returns to when he wants to review a topic or quickly refresh the details of a technique. “When I have to perform a block I’m less familiar with, it helps me quickly find information to fill in gaps in my memory.” It is a situation many clinicians will recognize. You know the block. You have learned anatomy. You may even have performed it before. But it has been a while, and before picking up the probe and needle, there are a few details you want fresh in your mind. For Christophe, that might mean revisiting the relevant anatomy, checking the ultrasound landmarks, or reviewing the technique […]