the objective of the present study was to compare the efficacy of TENS and parasternal block with local anesthetic infiltration in relieving pain during the first 24 h period following median sternotomy.
Patients experiencing pain after undergoing cardiac surgery may also experience prolonged immobilization, insufficient respiratory functions and the inability to cough due to median sternotomy. Invasive and noninvasive interventions such as epidural analgesia, local regional blockade and the use of intravenous (IV) opioids, are used for postoperative pain management. Transcutaneous electrical nerve stimulation (TENS) is a noninvasive technique that is effective for postoperative pain management. It has been demonstrated to produce effective analgesia and reduce postoperative opioid requirements in patients undergoing cardiac surgery, and it has no side effects. Parasternal local anesthetic infiltration around the sternum has been demonstrated to be useful in providing early postoperative analgesia, reducing opioid requirements and, therefore, producing a potential positive effect on recovery. The present prospective, randomized controlled study included 120 patients, 18 to 65 years of age, who were scheduled for elective valve repair or coronary artery bypass graft (CABG) surgery with cardiopulmonary bypass. A random number table was used to randomly allocate patients to one of three treatment groups to relieve postoperative pain during the first 24 h following median sternotomy: parasternal block group (parasternal block combined with levobupivacaine infiltration and PCA(patient controlled analgesia)); TENS group (TENS and PCA); or the control group (PCA alone).
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
PREVENTION
Masking
QUADRUPLE
Enrollment
120
parasternal block and PCA for sternotomy pain
TENS and PCA for sternotomy pain
PCA for sternotomy pain
Antalya Training and Research Hospital, Department of Anesthesiology and Reanimation
Antalya, Turkey (Türkiye)
Visual Analogue Scores
Time frame: Assessed 24 hours after to intensive care unit admission
Supplemental morphine used
Time frame: Assessed 24 hours after to intensive care unit admission
Extubation time
Time frame: Assessed 24 hours after to intensive care unit admission
Length of ICU stay
Time frame: Assessed 24 hours after to intensive care unit admission
Length of hospital stay
Time frame: Assessed 10 days after to intensive care unit admission
Supplemental tramadol used
Time frame: Assessed 24 hours after to intensive care unit admission
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