It was aimed to examine the effects of anterior chest wall blocks (PECS and SAP) performed for postoperative analgesia on pain scores assessed using the Visual Analog Scale (VAS), opioid consumption, duration of mechanical ventilation, time to first mobilization, ICU length of stay, postoperative nausea and vomiting (PONV), and block-related complications in adult patients undergoing coronary artery bypass grafting (CABG).
This prospective randomized controlled trial evaluated the postoperative analgesic efficacy of ultrasound-guided serratus anterior plane (SAP) block and PECS II block in adult patients undergoing elective coronary artery bypass grafting (CABG). Eligible patients were randomized into three groups: SAP block, PECS II block, and a control group receiving standard systemic analgesia without regional block. The primary outcome was postoperative pain intensity assessed by Visual Analog Scale (VAS) scores at predefined post-extubation time points. Secondary outcomes included total opioid consumption within the first 24 postoperative hours, postoperative nausea and vomiting (PONV), and block-related complications. Exploratory recovery-related outcomes included mechanical ventilation duration, time to first mobilization, and ICU length of stay. Recovery-related outcomes were analyzed descriptively and considered exploratory because ICU clinicians were not blinded and important perioperative confounders were not systematically collected.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
243
Ultrasound-guided serratus anterior plane (SAP) block performed with 30 mL of 0.25% bupivacaine.
Ultrasound-guided PECS II block performed using a two-injection technique with a total of 30 mL of 0.25% bupivacaine.
Van Yuzuncu Yil University Faculty of Medicine Department of anesthesiology and reanimation
Van, Tuşba, Turkey (Türkiye)
Postoperative pain intensity assessed using the Visual Analog Scale (VAS)
Pain intensity will be assessed using the Visual Analog Scale (VAS). The VAS is a 10-centimeter scale where 0 cm = "no pain" and 10 cm = "worst imaginable pain"; higher scores indicate worse pain intensity. Assessments will be performed at 4, 8, 12, and 24 hours after extubation.
Time frame: 4, 8, 12, and 24 hours after extubation
Postoperative nausea and vomiting (PONV) and block-related complications
Postoperative adverse events including nausea, vomiting, and block-related complications will be recorded.
Time frame: Within 24 hours after surgery
Exploratory ICU length of stay
Length of stay in the intensive care unit measured in hours from ICU admission
Time frame: From ICU admission until ICU discharge, assessed up to 30 days
Exploratory time to first mobilization
Time from ICU admission to first mobilization measured in hours
Time frame: From ICU admission until first mobilization, assessed up to 7 days
Exploratory mechanical ventilation duration
Time from ICU admission to successful extubation
Time frame: From ICU admission until successful extubation, assessed up to 7 days
Total opioid consumption within the first 24 postoperative hours
Total postoperative opioid consumption will be recorded as cumulative tramadol and pethidine doses administered within the first 24 postoperative hours and converted to intravenous morphine equivalents.
Time frame: Cumulative opioid consumption assessed during the first 24 postoperative hours
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