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NCT Number: NCT06553560

The Efficacy of PSB and Recto-intercostal Block Combination on Postoperative Pain in Patients Undergoing Cardiac Surgery Via Sternotomy: Case Series

The aim of this study was to investigate the effectiveness of the combination of Superficial Parasternal Block and Recto-Intercostal Fascial Plane Block in patient groups undergoing cardiac surgery via sternotomy by evaluating postoperative pain scores and analgesic consumption.

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Key information

Age range

18 year–85 year

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

About this study

Ten patients received a combination of parasternal block and recto-intercostal fascial plane block as an intervention. Patients received bilateral parasternal block and recto-intercostal fascial plane block with 0.25% bupivacaine (total volume 60 ml) in the operating room before surgery. All blocks will be performed after general anesthesia induction, before skin incision. All patients included in the study will be given 50 mg dexketoprofen and 1 g paracetamol intravenously (i.v.) 10 minutes before skin closure. All patients will be given 3x1 g iv paracetamol and 2x50 mg dexketoprofen within the first 24 hours postoperatively. Numerical rating scale (NRS) was used to assess pain at the 1st, 6th, 12th, 18th and 24th hours after surgery. Total morphine consumption was calculated using a patient-controlled analgesia (PCA) device. Tramadol was planned as rescue analgesic medication (maximum dose: 300 mg/day).

Who can participate

Healthy volunteers accepted: No

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

Inclusion criteria

  • Adult patients over 18 years of age who will undergo cardiac surgery with sternotomy under general anesthesia and who are in classes I-II-III according to the American Society of Anesthesiologists (ASA) risk classification.

Exclusion criteria

  • Patients who did not give consent,
  • patients with coagulopathy,
  • patients with signs of infection at the block application site,
  • patients using anticoagulants,
  • patients with local anesthetic drug allergies,
  • patients with unstable hemodynamics,
  • patients who could not cooperate during postoperative pain assessment

Treatment and study plan

Parasternal Block and Recto-İntercostal Fascial Plane Block

Other

Superficial PSB is performed with the patient in the supine position using a high-frequency linear USG probe. The probe is placed longitudinally 2 cm lateral to the sternal border to visualize the T2-T4 intercostal space and to identify the pectoralis major muscle, intercostal muscle, and pleura. 10 ml of 0.25% bupivacaine local anesthetic is administered between the pectoralis major and intercostal muscle using an in-plane approach with a 100 mm needle. In addition, a Recto-Intercostal Fascial Plane Block is performed with a high-frequency linear USG probe. The probe is placed 2-3 cm lateral to the xiphoid so that the rectus abdominis muscle and 6-7th cartilages are visualized. The needle is advanced to the plane between the costal cartilage and the rectus abdominis muscle using the in-plane technique and 1-2 ml of saline is injected. After observing the spread to the target plane, 20 ml of 0.25% bupivacaine is applied. The same process is repeated bilaterally.

Primary outcomes

  1. Comparing the numerical rating scale scores

    Time frame: Postoperative 24 hours

    Numerical rating scale will be used for pain assessment. The scores of the numerical rating scale changes between 0 to 10 points. 10 points mean "the most severe pain that the patient ever had". 0 point means "there is no pain." Higher scores mean worse outcome.

Secondary outcomes

  1. Comparing total morphine consumption

    Time frame: Postoperative 24 hours

    Postoperative analgesic need

Study contacts

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

Onur Avcı

CONTACT

[email protected]

+905301126408

Oğuz Gündoğdu

CONTACT

[email protected]

+905545945469

Sponsors and collaborators

Lead sponsor

Cumhuriyet University

Other

Registry information

Official study title

Investigation of the Postoperative Analgesic Effect of the Combination of Superficial Parasternal Block (PSB) and Recto-Intercostal(İC) Fascial Plane Block in Patients Undergoing Cardiac Surgery Via Sternotomy: Case Series

Important dates

Study start
2024
Primary completion
2024
Study completion
2024
First posted
Aug 14, 2024
Registry last updated
Aug 14, 2024

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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