On April 19, 2018, at the 43rd World Congress of Anesthesiology and Pain Management in New York, Vinmec became the first hospital in the world to announce successful open-heart surgeries using the Erector Spinae Plane (ESP) block technique.
The report, presented by Dr. Hồ Thị Xuân Nga from Vinmec Central Park International Hospital, highlighted the ability to completely eliminate pain during and after open-heart surgery without using high-dose morphine, leading to faster recovery times. This attracted significant attention from the surgical and anesthesiology community.
Eliminating "breathless" pain for patients
Open-heart surgery is a very common procedure for treating many cardiovascular diseases today. During heart surgery, patients often have to open the chest by cutting along the sternum or opening the side of the chest. To reduce pain, the usual method is to combine high-dose morphine and other painkillers. However, patients often still do not completely eliminate the pain. After heart surgery, they have to endure severe pain from the surgical wound, the sternum saw site, the drainage site, and the upper back area. Post-operative pain can also affect internal organs and lead to complications after heart surgery. Additionally, the use of morphine for pain relief can cause side effects such as prolonged recovery and hospital stay, nausea, vomiting, itching, respiratory depression, dependency, and chronic pain syndrome after surgery.
To address these issues, Vinmec doctors have applied a completely new regional anesthesia technique: inserting a catheter under the erector spinae muscle next to the spine from the back (ESP) to block pain signals before they reach the spine. This technique is absolutely safe and provides high pain relief effectiveness. By applying ESP, Vinmec has provided a pain-free surgical experience for hundreds of heart surgery patients over the past year.
Mrs. Trần Thị Ngọc Diệp (50 years old, Ho Chi Minh City) suffered from multiple complex heart diseases: mitral valve stenosis after valve repair, grade III heart failure, atrial fibrillation, severe pulmonary hypertension, and underwent surgery at Vinmec Central Park in early April 2018, using ESP. In 2008, she had previously undergone mitral valve repair surgery. The memory of the "breathless" pain from the previous surgery was still very clear, so one day after the surgery at Vinmec Central Park with the ESP technique, while still in intensive care, she wondered: "Why did I have surgery but not feel any pain?" Six days after the major surgery, Mrs. Diệp was discharged from the hospital.
Opening new prospects
Just six days of hospitalization for a severe heart failure patient undergoing a second surgery with many potential risks, experiencing pain-free surgery is beyond expectations for both the patient and the treating doctors. Since early 2017, hundreds of open-heart surgery patients at Vinmec have undergone major surgeries smoothly without pain, shortening the time for intubation, enabling early mobility, and reducing hospital stay duration.
The positive results at Vinmec have opened up prospects for applying this anesthesia method in many heart surgeries, attracting significant interest from doctors in Vietnam and around the world.
Behind this achievement of Vinmec Central Park is the continuous innovation and dedication of Professor Philippe Macaire, Director of the Anesthesiology and Pain Management Center at Vinmec Times City International Hospital. After Professor Ki Jinn Chin from Toronto Western Hospital (Canada) demonstrated ESP on cadavers in 2016, Professor Macaire refined the technique, ensuring its safety and effectiveness for practical application.
Congratulations to Dr. Hồ Thị Xuân Nga and Vinmec Hospital on their success at the conference. With the goal of becoming the first pain-free hospital without using morphine, Vinmec fully adheres to global training programs on enhanced recovery after surgery (ERAS). With the success of using ESP in open-heart surgery, Vinmec has made significant strides, leading the world in pain management for major surgeries without morphine.
To further enhance the effectiveness of ESP, Vinmec is collaborating with the University of Montpellier in France to develop a postgraduate training program on advanced regional anesthesia techniques. The 43rd World Congress of Anesthesiology and Pain Management took place from April 19-21, 2018, in New York, with over 4,000 anesthesiologists and 100 speakers presenting. This prestigious conference is held every four years.
