Deep Parasternal Intercostal Plane Block

Institute Arnault Tzanck, France128 enrolled

Overview

Cardiac surgery is a source of severe post operative pain witch can cause major respiratory complications due to non optimal post operative rehabilitation. Multimodal analgesia provides acceptable pain control , but does not seem sufficient during coughing or mobilization. The use of morphine also exposes patients to side effects (nausea, vomiting, pruritus, respiratory depression, chronic pain, ileus). Bleeding and hemodynamic risks of peridural and spinal aneshesia limits their use. The postoperative efficacy of deep parasternal intercostal plane block has not yet been evaluated sufficiently. The aim of this study is to evaluate the efficacity of TTMPB on the quality of postoperative recovery after cardiac surgery.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

DOUBLE

Enrollment

128

Conditions

Nerve Block

Interventions

The block is performed bilaterally in the 4th intercostal space. The probe is placed in the latero-median axis and a needle is placed latero-medially between the intercostal and transverse thoracic muscle. The solution is then injected under ultrasound control

Eligibility

Sex: ALLMin age: 18 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Patients requiring cardiac surgery with sternotomy Exclusion Criteria: * Emergency procedure * Procedures requiring lateral chest drainage * Hemodynamic instability * Severe kidney or liver failure * BMI \> 40 * Chronic pain * Allergy to local anesthesics * Pregnant woman * Long term opioïds use

Outcomes

Primary Outcomes

Quality of recovery 15 (QoR-15)

QoR-15 score : 0 to 150. Addition of 15 items note between 0 to 10 150 = perfect post operative recovery possible 0 = worst post operative recovery possible

Time frame: 24 hours after surgery

Secondary Outcomes

Total morphine consumption at 24 hours

Total morphine consumption, in milligrams, during the first 24 hours after surgery.