Effect of Bilateral Transversus Thoracis Muscle Plane Block in Patients Undergoing Coronary Artery Bypass Graft Surgery.

University Hospital, Montpellier100 enrolled

Overview

Coronary artery bypass graft surgery is the standard surgical treatment for coronary disease. However, there is no consensus on analgesic management in patients undergoing CABG. The aim of the study is to evualuate efficacy of bilateral transversus thoracis muscle plane (TTMP) block combined with systemic analgesia, compared to systemic analgesia only, in patients undergoing elective on-pump CABG surgery. Our main hypothesis is that a bilateral TTMP block performed after CABG surgery could reduce morphine consumption during the first 48 hours. The investigators conducted an age, gender and type of surgery-matched retrospective cohort study in the Montpellier University Hospital (France).

Study Type

OBSERVATIONAL

Enrollment

100

Conditions

Coronary Artery Disease Pain Syndrome

Interventions

Ultrasound guided Bilateral Transversus Thoracis Muscle Plane blockPROCEDURE

In the "TTMP block" group, an ultrasounded guided TTMP block was performed by an anesthesiologist, in ICU, before tracheal tube removal. Between the 4th et 5th rib, on each side, 40 ml of Ropivacaine 2 mg/ml, in association with Clonidine, was injected "single-shot" in the tranversus thoracis muscle plane. The targets of local anesthetic were the anterior branches of intercostal nerves from T2 to T6. Dexamethasone 8 mg was injected intravenously.

Eligibility

Sex: ALLMin age: 18 Years

Medical Language ↔ Plain English

Inclusion criteria: * To be over 18 * To be scheduled for CABG surgery in the center of the study during the study period. Exclusion criteria: * Chronic pain or opioid use before surgery * Recent thoracic regional analgesia (\< 1 month) * Preoperative dementia or other neurologic or psychiatric disease incompatible with VAS pain scoring. * Other technique of regional anesthesia (e.g. thoracic epidural) * Opposition to data collection Secondary exlusion criteria: * Postoperative prolonged sedation in ICU (\> 12 hours) * Postoperative surgical complication requiring surgical revision during the first two days. * Opposition to data collection expressed secondarily

Locations (1)

Uh Montpellier

Montpellier, France

Outcomes

Primary Outcomes

cumulative morphine consumption

cumulative morphine consumption during the first two days. cumulative morphine consumption on postoperative day 0, 1 and 2, including the morphine administered in intensive care unit, and on postoperative day 1 and 2.

Time frame: postoperative day 2

Secondary Outcomes

Postoperative pain assessed

Postoperative pain assessed by visual analog scale (VAS) scoring

Time frame: postoperative day 0, 1 and 2

Postoperative nausea and vomiting

Time frame: hospital day 7

Occurrence of prurit

Time frame: postoperative day 7

rate of Delirium

Time frame: postoperative day 7

rate of Constipation

Time frame: postoperative day 7

rate of Urinary retention

Time frame: until postoperative day 7

rate of Hypotension

Time frame: until postoperative day 7

Pleural drain duration

Time frame: day 20

Urinary catheter duration

Time frame: day 20

Duration of hospitalization in ICU

Time frame: day 20

In-hospital length of stay

Time frame: day 20

Occurrence of atrial fibrillation

Time frame: until postoperative day 7

rate of Pneumonia

Time frame: until postoperative day 7

acute kidney injury

Time frame: until postoperative day 7

Data from ClinicalTrials.gov

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