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NCT Number: NCT07599748

Parasternal and Adductor Canal Blocks in CABG

This randomized controlled trial evaluates the effectiveness of different postoperative analgesic strategies in patients undergoing coronary artery bypass graft (CABG) surgery. Patients were allocated into three groups receiving either conventional analgesia alone, parasternal block in addition to conventional analgesia, or combined parasternal and adductor canal blocks with conventional analgesia. The study aims to compare postoperative pain scores, opioid consumption, and recovery outcomes among the groups in order to determine whether the addition of regional anesthesia techniques, particularly the combined block approach, provides superior analgesia and enhances postoperative recovery following CABG surgery.

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Key information

Conditions

Postoperative Pain Agnosia Nervous System Diseases Neurobehavioral Manifestations Neurologic Manifestations Pain Pain Management Pain, Postoperative Pathologic Processes Pathological Conditions, Signs and Symptoms Perceptual Disorders Postoperative Complications Regional Anaesthsia Signs and Symptoms

Age range

18 year–80 year

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

Zonguladk Bulent ecevit University

Zonguldak, Turkey (Türkiye)

Who can participate

Healthy volunteers accepted: No

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

Inclusion criteria

  • Patients aged 18-80 years Patients classified as American Society of Anesthesiologists (ASA) physical status II-IV Patients scheduled for elective coronary artery bypass graft (CABG) surgery under general anesthesia Patients undergoing saphenous vein graft harvesting during CABG surgery Patients able to understand and use the Numeric Rating Scale (NRS) and Quality of Recovery-15 (QoR-15) questionnaire Patients who provided written informed consent to participate in the study

Exclusion criteria

  • Patient refusal to participate in the study Known allergy or hypersensitivity to local anesthetics, morphine, or study-related medications Emergency coronary artery bypass graft surgery History of chronic opioid use or opioid dependence Pre-existing chronic pain syndromes requiring regular analgesic treatment Cognitive impairment or inability to understand the Numeric Rating Scale (NRS) or Quality of Recovery-15 (QoR-15) questionnaire Coagulopathy or ongoing anticoagulant therapy contraindicating regional anesthesia techniques Local infection at the planned block sites Severe hepatic or renal dysfunction Previous surgery or anatomical abnormality preventing performance of the regional blocks Conversion to a surgical procedure other than planned CABG during the intraoperative period Hemodynamic instability requiring mechanical circulatory support or reoperation in the early postoperative period Patients requiring prolonged postoperative mechanical ventilation or deep sedation preventing postoperative pain assessment

Treatment and study plan

parasternal block

Procedure

Ultrasound-guided parasternal block was performed bilaterally after induction of general anesthesia in patients undergoing coronary artery bypass graft surgery. Following aseptic skin preparation, a high-frequency linear ultrasound probe was placed parallel to the sternum to identify the parasternal intercostal plane. A block needle was advanced under ultrasound guidance, and local anesthetic was injected into the interfascial plane adjacent to the sternum to provide anterior thoracic wall analgesia. The procedure was performed according to institutional standardized block protocols.

Parasternal block + Adductor canal block

Procedure

In addition to conventional analgesia, patients received ultrasound-guided bilateral parasternal block and adductor canal block after induction of general anesthesia. The parasternal block was performed by injecting local anesthetic into the interfascial plane adjacent to the sternum under ultrasound guidance to provide anterior thoracic wall analgesia. The adductor canal block was performed under ultrasound guidance by depositing local anesthetic within the adductor canal to provide analgesia at the saphenous vein graft harvesting site. All procedures were performed according to standardized institutional protocols.

conventional analgesic regimen

Other

Patients received standard postoperative analgesia consisting of intravenous patient-controlled analgesia (PCA) with morphine following coronary artery bypass graft surgery. The PCA device was initiated in the postoperative period according to institutional analgesia protocols, allowing patient-administered morphine dosing for pain control. Additional rescue analgesics were administered when clinically indicated.

Primary outcomes

  1. Postoperative opioid consumption

    Time frame: At postoperative 0,1, 2, 4, 8, 12, 24, 48, and 72 hours; total morphine consumption at 72 hours

    Postoperative opioid consumption will be assessed as the cumulative morphine dose administered via intravenous patient-controlled analgesia (PCA). Morphine consumption will be recorded at predefined postoperative time points, and total morphine consumption will be calculated at 72 hours after surgery.

Secondary outcomes

  1. Postoperative pain scores assessed using the Numeric Rating Scale (NRS)

    Time frame: At postoperative 0, 1, 2, 4, 8, 12, 24, 48, and 72 hours

    Postoperative pain intensity will be evaluated using the Numeric Rating Scale (NRS), where 0 indicates no pain and 10 indicates the worst imaginable pain. Pain scores will be recorded at predefined postoperative time points up to 72 hours after surgery.

  2. Quality of Recovery-15 (QoR-15) score

    Time frame: At postoperative 24 and 72 hours

    Postoperative recovery quality will be assessed using the Quality of Recovery-15 (QoR-15) questionnaire at 24 and 72 hours after surgery. The QoR-15 is a validated patient-reported outcome measure evaluating multiple domains of postoperative recovery, with higher scores indicating better recovery quality.

  3. Postoperative nausea and vomiting and antiemetic consumption

    Time frame: At postoperative 0, 1, 2, 4, 8, 12, 24, 48, and 72 hours

    Postoperative nausea and vomiting (PONV) will be evaluated at predefined postoperative time points using a standardized nausea-vomiting scoring system. The requirement for rescue antiemetic treatment and the total amount of antiemetic medication administered during the first 72 postoperative hours will also be recorded.

Study contacts

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

Merve Sena baytar, MD

CONTACT

[email protected]

+90 506 827 05 30

Sponsors and collaborators

Lead sponsor

Zonguldak Bulent Ecevit University

Other

Registry information

Official study title

Comparison of Postoperative Analgesic Efficacy of Parasternal Block and Parasternal Block Combined With Adductor Canal Block in Coronary Artery Bypass Graft Surgery: A Randomized Controlled Trial

Important dates

Study start
2026
Primary completion
2027
Study completion
2027
First posted
May 20, 2026
Registry last updated
May 20, 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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