Effect of Bilateral Transversus Thoracis Muscle Plane Block in Patients Undergoing Coronary Artery Bypass Graft Surgery. (PARACABS)

University Hospital Center (CHU)

Status: Completed

Conditions: Coronary Artery Disease; Pain Syndrome

Treatments: Procedure: Ultrasound guided Bilateral Transversus Thoracis Muscle Plane block

Study type: Observational

Funder types: Other

Identifiers

NCT04849117

RECHMPL19_0582

Details and patient eligibility

About

Coronary artery bypass graft surgery is the standard surgical treatment for coronary disease. However, there is no consensus on analgesic management in patients undergoing CABG.

The aim of the study is to evualuate efficacy of bilateral transversus thoracis muscle plane (TTMP) block combined with systemic analgesia, compared to systemic analgesia only, in patients undergoing elective on-pump CABG surgery.

Our main hypothesis is that a bilateral TTMP block performed after CABG surgery could reduce morphine consumption during the first 48 hours.

The investigators conducted an age, gender and type of surgery-matched retrospective cohort study in the Montpellier University Hospital (France).

Enrollment: 100 patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• To be over 18
• To be scheduled for CABG surgery in the center of the study during the study period.

Exclusion criteria

• Chronic pain or opioid use before surgery
• Recent thoracic regional analgesia (< 1 month)
• Preoperative dementia or other neurologic or psychiatric disease incompatible with VAS pain scoring.
• Other technique of regional anesthesia (e.g. thoracic epidural)
• Opposition to data collection

Secondary exlusion criteria:

• Postoperative prolonged sedation in ICU (> 12 hours)
• Postoperative surgical complication requiring surgical revision during the first two days.
• Opposition to data collection expressed secondarily

Trial design

100 participants in 2 patient groups

Systemic analgesia

Description:

Patients received only systemic analgesia : Acetaminophen, Ketoprofen, and Nefopam were administered systematically. Morphine was administered if necessary, according to our institutional pain management protocol.

Bilateral TTMP block + systemic analgesia

Description:

Patients received the same protocol of systemic analgesia associated with a bilateral TTMP block performed during the first four hours after ICU admission, before tracheal tube removal.

Treatment:

Procedure: Ultrasound guided Bilateral Transversus Thoracis Muscle Plane block