Patients experiencing pain after undergoing cardiac surgery may also experience prolonged immobilization, insufficient respiratory functions, and the inability to cough due to median sternotomy. Therefore, duration of mechanical ventilation, length of intensive care unit (ICU) stay, and length of hospital stay of these patients will increase significantly. many facial plane blocks have been introduced as simple and safe intervention for thoracic wall anesthesia and analgesia. Parasternal intercostal nerve block (PSIB) is a "superficial block" which involves local anesthetic (LA) infiltration in the intercostal space around the sternum where the anterior branches of intercostal nerves exist. Intraoperative LA administration under direct vision of the surgeon ensures adequate delivery of drugs and minimizes bleeding complication or inadvertent administration in blood vessels. Meanwhile, Preoperative administration of LA guided by ultrasound imaging has been used in variable surgical settings with noticeable success because of preemptive inhibition of noxious stimuli.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
PREVENTION
Masking
DOUBLE
Enrollment
51
LA will be administrated by the anesthesiologist under ultrasound guidance and before surgical incision On either side of thorax, 2 cm lateral to sternal edge from 2nd to 6th intercostal space, A volume of (4 mL) of 0.25% bupivacaine will be used
LA will be administered by the cardiac surgeon before the sternal closure. injection will introduced 2 cm lateral to sternal edge from 2nd to 6th intercostal space and volume (4 mL) of 0.25% bupivacaine will be used.
Samar Rafik Amin
Banhā, Qalyubia Governorate, Egypt
Amount of rescue analgesia
Total amount of opioid administered as rescue analgesia postoperative.
Time frame: 24 hours postoperative
Intraoperative total fentanyl requirements
the amount of consumed opioid during the procedure
Time frame: during surgery
intraoperative mean arterial blood pressure (MAP)
hemodynamic variability due to surgical stimulation
Time frame: during surgery (baseline, at skin incision, at sternotomy, at sternal retraction)
pain score (VAS)
VAS scores will be recorded by making a handwritten mark on a 10-cm line that represented a continuum between "no pain" and "worst possible pain."
Time frame: at extubation, 12th, 16th, 20th, and 24th hour postoperative
adverse effects
nausea, vomiting, excessive sedation, respiratory depression
Time frame: 24 hours postoperative
patient satisfaction
0 "extremely unsatisfied" to 10 "extremely satisfied"
Time frame: 28 hours postoperative
Intensive Care Unit (ICU) Length of Stay
Time frame: up to 6 months
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