Pecto-Intercostal Fascial Block vs. Transversus Thoracic Muscle Plane Block in Cardiac Surgery

Ondokuz Mayıs University

Status

Completed

Conditions

Coronary Artery Disease

Pain, Postoperative

Treatments

Procedure: Single-injection, ultrasound-guided bilateral TTMP block.

Procedure: Single-injection, ultrasound-guided bilateral PIF block.

Study type

Interventional

Funder types

Other

Identifiers

NCT04791592

PIFB-TTPB19

Details and patient eligibility

About

In patients undergoing open cardiac surgery, pain control is an essential part of the enhanced recovery process. The current study aimed to evaluate the analgesic efficacies of ultrasound-guided pecto-intercostal fascial block and ultrasound-guided transversus thoracic muscle plane block for open cardiac surgeries. Analgesic efficacy will be assessed on the numeric rating scale (NRS) along with intraoperative and 24 h postoperative opioid consumption.

Full description

It has been reported that the TTMP block and PIF block produce effective postoperative analgesia for open cardiac surgeries.

The hypothesis of our study; PIF block reduces pain and analgesic consumption in the acute period (0-24 hours) similar to TTP block in patients undergoing elective cardiac surgery requiring median sternotomy.

Patients will be divided into two groups:

Group PIFB: A bilateral PIF block will be performed intraoperatively (20 ml, %0.25 bupivacaine + 1:400.000 adrenaline). In addition, IV morphine patient-controlled analgesia (PCA) will be applied postoperatively for 24 hours.

Group TTMPB: A bilateral TTMP block will be performed intraoperatively (20 ml, %0.25 bupivacaine + 1:400.000 adrenaline). In addition, IV morphine-PCA will be applied postoperatively for 24 hours.

Enrollment

42 patients

Sex

All

Ages

18 to 80 years old

Volunteers

No Healthy Volunteers

Inclusion criteria

ASA 1-3 patients between the ages of 18-80 who are scheduled for elective cardiac surgery (coronary artery bypass graft surgery with median sternotomy +/- valve replacement or isolated valve surgery)
BMI <35 kg / m2

Exclusion criteria

Emergent surgeries, redo cases, minimally invasive procedures
Patients who do not want to participate
Patients with cognitive dysfunction (patients who are not able to evaluate the verbal numerical pain scale)
Hypersensitivity or history of allergies to local anesthetics
Patients with severe major organ dysfunction (such as renal or hepatic insufficiency)
LVEF <30
Patients with psychiatric disorders
Pregnancy or breastfeeding
Presence of hematological disease
Patients with alcohol-drug addiction
Patients who use daily opioids for any reason