Comparison of the Analgesic Efficacy of… | Clinical Trial

Key information

Conditions

Coronary Arterial Disease (CAD) Postoperative Analgesia Serratus Anterior Muscle Plane Block Transversus Thoracis Muscle Plane Block

Age range

18 year–80 year

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

Ankara Bilkent City Hospital, Ankara, Turkey (Türkiye)

About this study

Postoperative pain is a critical risk factor for the development of pulmonary and cardiovascular complications in coronary artery bypass graft (CABG) surgery. If effective respiratory function cannot be maintained in patients with high pain levels, atelectasis, cardiac ischemia, and arrhythmias may be observed. This prolongs the hospital discharge time of patients and increases the frequency of postoperative pulmonary complications and postoperative morbidity. Moreover, if postoperative acute pain is not adequately treated, chronic pain may develop after surgery, preventing patients from regaining their normal activities for a long time. In addition to medications, various neuroaxial and peripheral nerve blocks can be used in cardiac surgery. The use of intraoperative heparin limits the application of neuroaxial anesthesia (thoracic epidural and intrathecal opioids) and paravertebral block due to potential complications. Nevertheless, studies have shown their benefits in reducing cardiac and pulmonary complications. Recently, fascial plane nerve blocks, which are alternatives to these methods, have gained more popularity in cardiovascular surgery. These blocks include pectoral nerve blocks, serratus anterior plane block (SAPB), erector spinae plane block (ESPB), transverse thoracic plane blocks (TTMP), pecto-intercostal fascial blocks (PIF), and intercostal nerve blocks. The inability to effectively prevent postoperative pain in cardiac surgery has led not only to the exploration of new block applications but also to the combination of these blocks.

Who can participate

Healthy volunteers accepted: Yes

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

Inclusion criteria

Patients aged 18-80
Patients with ASA score I-II-III
Patients with a body mass index (BMI) between 18-35
Patients undergoing sternotomy in the operating room

Exclusion criteria

Patients under 18 and over 80 years of age
Patients with an ASA score of IV or higher
Patients with advanced comorbidities
Patients with a history of bleeding diathesis
Patients using medications that cause bleeding disorders
Patients with infections in the area where the block will be performed
Patients with a body mass index (BMI) below 18 or above 35

Treatment and study plan

The patient group receiving deep and superficial serratus anterior plane block

Procedure

The ultrasound device to be used , the type of single-use ultrasound-compatible block needle, the type of local anesthetic agent to be administered to the patient, the concentration of the local anesthetic agent, and the total dose of the local anesthetic agent to be administered to the patient will be the same.

The patient group receiving a combination of deep serratus anterior plane block and transverse thoracic muscle plane block

Procedure

The ultrasound device to be used , the type of single-use ultrasound-compatible block needle, the type of local anesthetic agent to be administered to the patient, the concentration of the local anesthetic agent, and the total dose of the local anesthetic agent to be administered to the patient will be the same.

Primary outcomes

Comparison of the Analgesic Efficacy of Deep and Superficial Serratus Anterior Plane Block with the Combination of Deep Serratus Anterior Plane and Transverse Thoracic Muscle Plane Block in Coronary Artery Bypass Surgery: A Randomized Controlled Trial

Time frame: postoperative 24 hours

Postoperative pain intensity will be assessed using the Visual Analog Scale (VAS), ranging from 0 to 10, where 0 indicates no pain and 10 indicates the worst imaginable pain. Higher VAS scores indicate worse pain outcomes. Pain scores will be recorded by the pain nurse in the postoperative post-anesthesia care unit (PACU), where patients are routinely monitored for 24 hours. Additional postoperative analgesic consumption and patient satisfaction will also be assessed. For descriptive analysis, pain intensity will be categorized as mild (VAS <3), mild to moderate (VAS 3-6), and moderate to severe (VAS >6).

Sponsors and collaborators

Lead sponsor

Ankara City Hospital Bilkent

Other

Registry information

Important dates

Study start: 2024
Primary completion: 2024
Study completion: 2024
First posted: Oct 24, 2024
Registry last updated: Mar 25, 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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Completed