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NCT Number: NCT07794527

Efficacy of Multiple Nerve Blocks on the Recovery of Patients Undergoing Off Pump CABG Surgeries

In cardiac surgery patients , effective pain control is crucial to support early extubation, mobilization, and cognitive recovery, yet systemic opioids carry substantial risks such as respiratory depression, delirium, and delayed rehabilitation. While regional fascial plane blocks offer a safer, opioid-sparing alternative, no single technique provides complete analgesia for the complex and multi-dermatomal pain generated by sternotomy, graft harvesting, chest wall retraction, and drain sites. Therefore, a multimodal approach combining blocks such as parasternal nerve block , rectus sheath nerve block and femoral nerve block , may cover most of areas expected to be sources of intraoperative and post-operative pain in cardiac surgery patients.

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Key information

Conditions

Ischemic Heart Disease (IHD) Cardiovascular Diseases Heart Diseases Myocardial Ischemia Off-Pump Coronary Artery Bypass Regional Block for Pain Control Vascular Diseases

Age range

18 year–65 year

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

Ain shams university hospitals

Cairo, Egypt

Location status: Recruiting

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • o Scheduled for elective off-pump coronary artery bypass graft (OPCAB) surgery via median sternotomy
  • American Society of Anesthesiologists (ASA) physical status III - IV
  • Ability to provide informed consent

Exclusion criteria

  • o Emergency or redo cardiac surgery
  • On-pump CABG or concomitant valve or aortic procedures
  • Known allergy to local anesthetics or study drugs
  • Coagulopathy or ongoing anticoagulant therapy contraindicating regional block
  • Preoperative chronic opioid use or opioid dependency
  • Neurologic or psychiatric conditions interfering with pain assessment
  • Infection at the block injection site
  • Severe hepatic or renal impairment
  • Body mass index (BMI) > 40 kg/m²
  • Inability to understand or cooperate with pain scoring or postoperative care.

Treatment and study plan

regional nerve block with local anesthesia

Procedure

Patients will receive bilateral superficial parasternal nerve block using 20 mL of 0.25% bupivacaine per side, in combination with a rectus sheath block (RSB) using 10 mL of 0.25% bupivacaine per side. and femoral nerve block at the side of harvesting using 10 mL of 0.25% bupivacaine.

Placebo

Procedure

Patients will receive placebo (saline) injections administered in the same anatomical planes.

Primary outcomes

  1. Time to Extubation

    Time frame: from transferal to ICU until successful tracheal extubation assessed during post operative ICU stay up to 48 hours

    Defined as the interval (in hours) from transferal to ICU to successful tracheal extubation

Study contacts

Contact information is provided by the study sponsor or research team.

Abdelrahman H Ashour

CONTACT

[email protected]

+2-1010184467

Sponsors and collaborators

Lead sponsor

Ain Shams University

Other

Registry information

Official study title

Enhancement of the Recovery Profile in Patients Undergoing Off-Pump Coronary Artery Bypass Graft Surgery Through Combination of Multiple Regional Nerve Blocks

Important dates

Study start
2026
Primary completion
2027
Study completion
2027
First posted
Aug 31, 2026
Registry last updated
Aug 31, 2026

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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