Authors: Cha YM et al.
Source: The Daily Dose — Friday, May 8, 2026
Coverage from the 2026 Annual Meeting presented by the International Anesthesia Research Society (IARS) and Society of Critical Care Anesthesiologists (SOCCA)
At the 2026 IARS/SOCCA Annual Meeting late-breaking clinical trials session, C. David Mazer presented findings from the EPOCH CardioLink-10 trial, which evaluated the effectiveness of superficial parasternal intercostal plane (SPIP) blocks for postoperative pain control after cardiac surgery performed through median sternotomy.
Pain management following sternotomy remains a major perioperative challenge. Poorly controlled postoperative pain can contribute to persistent chronic pain, prolonged opioid use, pulmonary complications, delayed mobilization, and longer hospital stays. Regional anesthesia techniques designed specifically for sternotomy pain have therefore become an area of increasing interest in cardiac anesthesia.
The EPOCH CardioLink-10 study was designed as a multicenter, double-blind, placebo-controlled randomized trial to determine whether SPIP blocks could reduce opioid exposure during the first 72 hours after cardiac surgery.
In the study, catheters were placed under ultrasound guidance between the pectoralis major muscle and intercostal muscles to deliver regional analgesia targeting the anterior chest wall.
Although the detailed data remain under embargo pending publication, the conference presentation reported favorable results for SPIP blocks. Investigators noted reduced opioid requirements without meaningful differences in safety outcomes or complication rates compared with placebo controls.
These findings are potentially important because enhanced postoperative pain control following sternotomy may improve pulmonary function, accelerate mobilization, reduce opioid exposure, and potentially shorten recovery time after cardiac surgery.
The study may also strengthen the growing body of evidence supporting regional anesthesia in cardiothoracic surgery. Investigators noted that the findings could contribute to evidence referenced in the recently published 2026 ASA Practice Guidelines on perioperative pain management using local and regional analgesia techniques for cardiothoracic, mastectomy, and abdominal surgery patients.
Because these findings were presented during a conference late-breaking session, full peer-reviewed publication is still pending.
Key Points
• EPOCH CardioLink-10 evaluated SPIP blocks after cardiac surgery via median sternotomy
• The study was a multicenter, double-blind, placebo-controlled randomized trial
• SPIP blocks appeared to reduce postoperative opioid exposure over 72 hours
• Safety outcomes and complication rates were similar between groups
• Ultrasound-guided catheters were placed between the pectoralis major and intercostal muscles
• Findings may support expanding use of regional anesthesia techniques in cardiac surgery
• Full data remain embargoed pending publication
Thank you to IARS and SOCCA for allowing us to summarize and share these important perioperative medicine conference findings.