This study aims to assess the impact of bilateral deep parasternal intercostal plane block on intraoperative opioid consumption in open heart surgery
High-dose opioid is associated with various side effects such as nausea, vomiting, urinary retention, and respiratory depression. The neuraxial block (intrathecal, epidural) and peripheral nerve block are regional anesthesia techniques which have the potential to reduce intraoperative opioid consumption. The deep parasternal intercostal plane block is fascial plane block which intended to block anterior cutaneous branch of intercostal nerves. This study is a double-blind randomized controlled trial. Thirty subjects will be recruited with consecutive sampling method. Eligible subjects with signed informed consent will be randomized into two groups. The first group is the treatment group who will receive bilateral deep parasternal intercostal plane block after induction of anesthesia and the second group will be the control group who will not receive any regional anesthesia. After surgery, extubation time, adverse event (nausea, vomiting), and intensive care unit length of stay will be recorded for both groups.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
30
Twenty milliliters of 0.25% bupivacaine will be placed bilaterally in the fascial plane between internal intercostal muscle and transversus thoracis muscle at intercostal space 4 or 5, lateral from sternum, with ultrasound guidance using high-frequency linear transducer.
Skin puncture with needle will be performed on the same location as the treatment group without administration of local anesthetics.
Cipto Mangunkusumo Cental National Hospital
Jakarta, DKI Jakarta, Indonesia
RECRUITINGUniversitas Indonesia
Central Jakarta, Indonesia, Indonesia
RECRUITINGTotal intraoperative fentanyl dose
Total intraoperative fentanyl dose will be calculated after surgery
Time frame: intraoperatively
Time to first intraoperative fentanyl
Investigators will record time to first fentanyl dose after incision
Time frame: intraoperatively
extubation time
Investigators will record time to extubation after surgery
Time frame: Up to 72 hours after surgery
opioid side effects
Incidence of nausea and vomiting
Time frame: within 24 hours after surgery
Intensive care unit length of stay
Investigators will record total time from intensive care unit admission until patient transferred to surgical wars
Time frame: Up to 7 days after surgery
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