Transversus Thoracic Plane Block for Perioperative Analgesia in Cardiac Surgery

N/ANot Yet RecruitingNCT06546722

Saint-Joseph University150 enrolled

Overview

The goal of this clinical trial is to learn if perioperative Transversus Thoracic Plane Block (TTPB) decrease perioperative pain after cardiac surgery. The main questions it aims to answer are: 1. does Transversus Thoracic Plane Block decrease perioperative pain after cardiac surgery more than the standard analgesic treatment? 2. Are the results different if the investigators perform Transversus Thoracic Plane Block before surgery or at the end of surgery?

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

SUPPORTIVE_CARE

Masking

DOUBLE

Enrollment

150

Conditions

Transversus Thoracic Plane Block Cardiac Surgery Post Operative Pain

Interventions

The Transversus Thoracic Plane Block is a recent regional anesthesia technique. It provides analgesia for the anterior cutaneous branches of the intercostal nerves T2-6 to the medial anterior chest wall via a single injection of local anesthesia between the internal intercostal muscle and the transversus thoracic muscle located between the third and fourth (or fourth and fifth) intercostal space. It is noteworthy that the TTPB can consequently reduce pulmonary morbidity and the need for high-dose opioids.

Eligibility

Sex: ALLMin age: 18 Years

Medical Language ↔ Plain English

Inclusion Criteria: \- All patients scheduled for cardiac surgery via sternotomy under cardiopulmonary bypass Exclusion Criteria: * Previous cardiac surgery * Urgent surgery * Pregnant women * Allergy to local anesthetics * Opioid dependence * Low ejection fraction \< 30% * Presence or onset of cognitive or neurological disorders preventing pain assessment * Infection at injection sites * Coagulopathy * Patients on dual antiplatelet therapy * Renal insufficiency with Glomerular filtration rate (GFR) \< 30 mL/min * History of thoracic radiotherapy * History of mastectomy

Outcomes

Primary Outcomes

postoperative pain score

The primary outcome is Postoperative Pain Score: Numeric rating scale (NRS) ratings will be assessed at T1 (= upon patient awakening), T2 (= 12 hours postoperatively), T3 (= 24 hours postoperatively) as well as during various painful moments (coughing, drain removal, mobilization). Numeric rating scale (NRS) is a unidimensional measure of pain intensity. It consists of the patient evaluating his pain out of a series of numbers ranging from 0 to 10, where the 2 respective endpoints are "0 = no pain" and "10 = worst possible pain."