Erector Spina Block or Parasternal Block Plus Chest Tube Wound Infiltration for Cardiac Surgeries

TC Erciyes University

Status: Not yet enrolling

Conditions: Postoperative Pain; Analgesia; Postoperative Atelectasis

Treatments: Procedure: Comparison of erector spina plane block, parasternal block plus local infiltration to the tube sides for postoperative analgesia

Study type: Interventional

Funder types: Other

Identifiers

NCT06267443

2023/337

Details and patient eligibility

About

Pain management is important after coronary artery bypass graft (CABG) surgery. Intravenous morphine is the gold standard for pain relief, but its sedation, cough suppression and decreased bowel movements limit its use. Analgesia with regional methods after surgery provides effective analgesia by reducing morphine consumption. In this study we have planned to compare the erector spina plane block with parasternal block +local infiltration to chest tube areas.

Full description

Patients who will undergo open heart surgery will be included in this study. Pain management is important after coronary artery bypass graft (CABG) surgery. Poorly controlled postoperative pain can trigger myocardial ischemia, increase catecholamine levels, result in increased complications such as stroke and bleeding, and increase the risk of pneumonia. Intravenous morphine is the gold standard for pain relief, but its sedation, cough suppression and decreased bowel movements limit its use. For this reason, regional methods are gaining importance in pain treatment. After cardiac surgery. Both sternotomy and bilateral chest tubes are the most painful interventions during cardiac surgeries. Parasternal block can be a good alternative in the treatment of pain in CABG surgeries. In parasternal application, the aim is to anesthetize the nerves innervating the sternum between the pectoral muscle and the intercostal muscle by holding the probe in the parasagittal plane on the lateral side of the sternum under USG guidance. Patients who will undergo open heart surgery will be included in this study. The patients will be divided into two groups, and in Group 1, before general anesthesia is given, bilateral ESPB will be performed at the 4-6th thoracic level in the prone position, and then routine general anesthesia will be performed (at this stage, the patients will be given sedation to prevent them from feeling pain). After endotracheal intubation, in Group 2, a parasternal block will be performed from the lateral sternum. At the end of the surgery, local anesthetic infiltration will be perform to the tube sites. General anesthesia and surgical procedures will be performed routinely in both groups. In the intensive care unit patients will be monitored for pain levels, intubation duration, whether there is atelectasis in the lungs, and the need for reintubation. Pain assessment will be evaluated with the behavioral pain score while the patients are intubated and with the visual pain scale after extubation. Whether atelectasis has developed will be evaluated with ultrasonography at the 12th and 24th hours postoperatively

Enrollment: 100 estimated patients

Sex: All

Ages: 18 to 80 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

1. Patients who will undergo open heart surgery
2. Patients who agreed to participate in the study-

Exclusion criteria

1. Patients who do not agree to participate in the study
2. Patients with chronic lung disease
3. Patients with D. Mellitus

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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100 participants in 2 patient groups

Group 1

Active Comparator group

Description:

in this group erector spina plane block will be performed before surgery for post operative analgesia

Treatment:

Procedure: Comparison of erector spina plane block, parasternal block plus local infiltration to the tube sides for postoperative analgesia

Group 2

Active Comparator group

Description:

in this group after endotracheal intubation bilateral parasternal block will be performed and to the chest tube sides local anesthetic infiltration will be performed

Treatment:

Procedure: Comparison of erector spina plane block, parasternal block plus local infiltration to the tube sides for postoperative analgesia