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

C

Cumhuriyet University

Status

Not yet enrolling

Conditions

Post Operative Pain

Treatments

Other: Parasternal Block and Recto-İntercostal Fascial Plane Block

Study type

Interventional

Funder types

Other

Identifiers

NCT06553560
PSB and Recto-İC in sternotomy

Details and patient eligibility

About

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.

Full description

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).

Enrollment

10 estimated patients

Sex

All

Ages

18 to 85 years old

Volunteers

No Healthy Volunteers

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

Trial design

Primary purpose

Other

Allocation

N/A

Interventional model

Single Group Assignment

Masking

None (Open label)

10 participants in 1 patient group

Parasternal Block and Recto-İntercostal Fascial Plane Block
Other group
Description:
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.
Treatment:
Other: Parasternal Block and Recto-İntercostal Fascial Plane Block

Trial contacts and locations

0

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Central trial contact

Onur Avcı; Oğuz Gündoğdu

Data sourced from clinicaltrials.gov

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