The aim of this randomized controlled trial is to examine the effect of ultrasound guided bilateral Parasternal Nerve Block combined with rectus sheath block on preoperative analgesia, opioid consumption and respiratory function in patients undergoing cardiac surgery via sternotomy. Half of participants will receive General Anesthesia combined with bilateral parasternal block and rectus sheath block while the other half receive General Anesthesia combined with bilateral parasternal block and infiltration of drainage exits sites with local anesthetic (without performing rectus sheath block)
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
58
After induction of general anesthesia, an ultrasound-guided Parasternal Block will be performed with 20 mL of ropivacaine 0.5 % per side.
At the end of surgery, a local infiltration of drainage exit sites will be performed with 10 mL of ropivacaine 0.25% per side
At the end of surgery, a rectus sheath block will be performed with 10 mL of ropivacaine 0.25% per side.
Campus Bio-medico University Hospital Foundation
Rome, Italy
Static Pain Score
A numerical rating scale (NRS) from 0 (no pain) to 10 (worst imaginable pain) will be used to evaluate pain at rest during 24 hours after surgery
Time frame: 24 hours
Dynamic Pain Score
A numerical rating scale (NRS) from 0 (no pain) to 10 (worst imaginable pain) during movement will be used to evaluate pain at rest during 24 hours after surgery
Time frame: 24 hours
Intraoperative Fentanyl Consumption
Total intravenous fentanyl administration (expressed in milligrams) during surgery
Time frame: 4 hours
Morphine Consumption
Total of intravenous morphine (expressed in milligrams) administered during the first 24 hours after surgery
Time frame: 24 hours
Time of Extubation
Interval between the end of surgery and patient's extubation
Time frame: 48 hours
Respiratory performance at incentive spirometry
Respiratory performance is assessed preoperatively and postoperatively (at extubation) by the number of balls raised during inspiration with the TRI-FLOW spirometer
Time frame: 48 hours
Intensive Care Unit (ICU) Discharge Time
Interval between patient arrival in ICU and discharge from ICU
Time frame: 120 hours
Hospitalization Length of Stay
Total Hospital length of Stay (expressed in days)
Time frame: 30 days
Incidence of adverse events
Any complications or side effects of the blocks, such as local infection, intravascular injection of local anesthetics and immediate systemic toxicity. Moreover, incidence of nausea, vomiting and postoperative respiratory complications will be recorded.
Time frame: 24 hours
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