Comparison of Sensory Analysis After Superficial and Deep Parasternal Intercostal Plane Blocks

Ondokuz Mayıs University

Status: Completed

Conditions: Pain, Postoperative

Treatments: Other: Sensory Assessment

Study type: Observational

Funder types: Other

Identifiers

NCT06559683

SensoryParasternal

Details and patient eligibility

About

Postoperative pain following cardiac surgery is a common issue that can negatively impact patients' quality of life. Effective perioperative pain management is crucial to improving patient outcomes. Pain is typically most intense during the first two postoperative days, and inadequate management can lead to chronic pain, further diminishing quality of life. Recent advances in ultrasound-guided regional anesthesia, including superficial and deep parasternal intercostal plane blocks, have enhanced acute pain control. These blocks aim to provide analgesia by targeting the anterior cutaneous branches of the T2-6 thoracic nerves. While their efficacy is recognized, sensory evaluation and dermatomal analysis remain unexplored. Cadaver studies suggest that the deep block may cover more parasternal space than the superficial block.

Full description

This observational study evaluates sensory blocks in patients undergoing open-heart surgery who receive superficial or deep parasternal intercostal plane blocks. Sensory assessment, conducted by a blinded researcher 30 minutes post-block, involves applying small ice tubes with cold sensations categorized as Normal, Reduced, or No cold. A successful block is defined as the loss or reduction of cold sensitivity, while normal cold sensation indicates block failure. Assessments start at the midline, moving laterally to the anterior axillary line. Marked areas are digitally analyzed. Block regression is evaluated at 12 and 24 hours post-procedure using the same cold assessment criteria.

Enrollment: 33 patients

Sex: All

Ages: 18 to 85 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Patients who will undergo effective open heart surgery with median sternotomy
• Patients who have undergone superficial or deep parasternal intercostal plane block

Exclusion criteria

• Patients with severe psychiatric illnesses such as psychosis or dementia that would prevent communication with the patient
• Patients who do not want to participate in the study
• Redo surgeries
• Patients whose block is considered unsuccessful with the cold application test at the 30th minute
• Patients who cannot be extubated 12 hours post-block.

Trial design

33 participants in 2 patient groups

Deep Parasternal

Description:

Patients scheduled for open-heart surgery will receive a deep parasternal intercostal plane block preoperatively, and sensory block status will be evaluated 30 minutes later using small ice tubes.

Treatment:

Other: Sensory Assessment

Superficial Parasternal

Description:

Patients scheduled for open-heart surgery will receive a superficial parasternal intercostal plane block preoperatively, and sensory block status will be evaluated 30 minutes later using small ice tubes.

Treatment:

Other: Sensory Assessment