Effects of TTPB vs PIFB on Opioid Consumption in Patients After Cardiac Surgery.

Beni-Suef University80 enrolled

Overview

The objective of this study is to compare the effects of TTPB vs PIFB on postoperative opioid consumption in patients undergoing open cardiac surgery.

Cardiac surgery performed through median sternotomy is associated with significant postoperative pain.Poststernotomy pain leads to decreased patient satisfaction, delirium, cardiovascular complications (hypertension, tachycardia, arrhythmias), hyperglycemia and respiratory complications (bronchial secretion stasis, atelectasis and pneumonia).High-dose opioids can provide good postoperative analgesia for patients undergoing heart surgery. However, opioids have some side effects.The advent of ultrasound-guided regional anaesthesia led to the development of fascial plane chest wall block as transthoracic plane block and pectointercostal fascial block.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

SINGLE

Enrollment

Conditions

Pain Postoperative

Interventions

Transversus thoracic plane blockPROCEDURE

TTPB group will receive bilateral ultrasound-guided transversus thoracic muscle plane block using 20 ml of bupivacaine 0.25% for each side.

Pecto intercostal fascial blockPROCEDURE

PIFB group will receive bilateral ultrasound-guided Pecto-intercostal fascial plane block using 20 ml of bupivacaine 0.25% for each side.

Eligibility

Sex: ALLMin age: 18 YearsMax age: 75 Years

Medical Language ↔ Plain English

Inclusion Criteria: 1. Age between 18 and 75 years. 2. Patient scheduled to undergo elective on-pump cardiac surgery with sternotomy. 3. American Society of Anesthesiologists classification of physical status \< IV. Exclusion Criteria: 1. Emergency surgery. 2. Off-pump surgery. 3. Redo surgery. 4. Ejection fraction less than 35%. 5. Refusal of the patient. 6. Known hypersensitivity to LA. 7. Chronic opioid use or chronic pain patient. 8. Psychiatric problems or communication difficulties. 9. Liver insufficiency (defined as a serum bilirubin ≥ 34 μmol/l, albumin ≤ 35 g/dl, INR ≥ 1.7) 10. Renal insufficiency (defined as a glomerular filtration rate \< 44 ml/min). 11. Obstructive sleep apnea syndrome. 12. Coexisting hematologic disorders. 13. Pregnancy or breastfeeding.

Locations (1)

Benisuef University Hospital

Benisuef, Egypt

RECRUITING

Outcomes

Primary Outcomes

The primary outcome will be total morphine consumption

Total morphine consumption within 24 hours according Visual Analogue Score (VAS) for sternal pain both during rest and with cough (ranging from 0 indicating no pain to 10 indicating extreme pain). A score ≤ 3 was considered acceptable for pain relief. Supplementary rescue analgesia was administered in the form of morphine IV 0.05 mg/kg (at VAS ≥ 4).

Time frame: 24 hours

Secondary Outcomes

The secondary outcomes will be the first analgesic request time

Is the time to ask for the first postoperative analgesia (morphine), and will be calculated from extubation to patient reporting Visual Analogue Score (VAS) ≥ 4.

Time frame: 24 hours

Central Contacts

Mariana A Mansour, lecturer

CONTACT

01222960009 mrmrsyk4@gmail.com

Data from ClinicalTrials.gov

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