Transversus Thoracis Muscle Plane Block for Postoperative Pain in Adult Cardiac Surgery

Muğla Sıtkı Koçman University75 enrolled

Overview

Inadequate pain control after coronary artery bypass graft surgery increases mortality and results in a higher incidence of persistent poststernotomy pain syndrome. Our aim is to assess whether ultrasound-guided parasternal intercostal block (PSIB) or surgeon implied transversus thoracic muscle plane block (TTMPB) would improve the postoperative pain scores and decrease tramadol consumption better after coronary artery bypass graft surgery

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

TRIPLE

Enrollment

Conditions

Postoperative Pain Chest Pain Coronary Artery Bypass Sternotomy

Interventions

Parasternal Intercostal Plane BlockPROCEDURE

40 ml %0.375 bupivacaine injection will be performed by ultrasound guidance after completion of surgery between pectoralis major muscle and external intercostal muscle at the 2nd and 3rd intercostal space and 4th and 5th intercostal space bilaterally by anesthesiologist.

Eligibility

Sex: ALLMin age: 45 YearsMax age: 80 Years

Medical Language ↔ Plain English

Inclusion Criteria: * American Society of Anesthesiologists physical status II-III * Elective coronary artery bypass graft surgery under general anesthesia Exclusion Criteria: * American Society of Anesthesiologists physical status IV * Emergency surgery and redo surgery * Low cardiac output syndrome, perioperative intra-aortic balloon pump support for any reason, bleeding disorder or abnormal coagulation profile, abnormal hepatic and renal parameters, uncontrolled diabetes mellitus, chronic obstructive pulmonary disease, atrial fibrillation on anticoagulation * Allergy to any study drugs, local infection at the block site * Opioid abuse

Outcomes

Primary Outcomes

Postoperative opioid consumption

Tramadol consumption will be assessed by checking patient daily drug order records

Time frame: Postoperative 24th hour

Postoperative opioid consumption

Tramadol consumption will be assessed by checking patient daily drug order records

Time frame: Postoperative 1st, 4th and 12th hour

Secondary Outcomes

Behavioral Pain Scale

A blinded nurse will assess postoperative pain while they are intubated at the 1st and 4th hour by using 3 subscale Behavioral Pain Scale which ranges from 3 (no pain) to 12 (maximum pain)

Time frame: postoperative 1st and 4th hour

Numeric Rating Scale

A blinded nurse will assess postoperative pain during resting and movement at postoperative 12th and 24th hour by using Numeric rating scale at the extubated patient by using 11-point Numerical Rating Scale which ranges from '0' (means no pain) to '10' (means worst pain imaginable)

Time frame: Postoperative 12th and 24th hour