This study evaluated the effects of parasternal block and wound site infiltration on postoperative pain in patients undergoing median sternotomy. Patients were allocated to receive parasternal block, wound site infiltration, or standard systemic analgesia. Salivary opiorphin levels and postoperative pain scores were assessed to compare analgesic effectiveness between the groups.
This randomized prospective study included patients undergoing surgery through median sternotomy. The study compared three perioperative analgesic approaches: parasternal block, wound site infiltration, and standard systemic analgesia without local intervention at the surgical site. Salivary samples were collected before surgery, after sternotomy, and during the postoperative period to measure opiorphin levels. Postoperative pain was assessed using visual analogue scale scores, and additional analgesic requirement, opioid consumption, extubation time, intensive care unit stay, and adverse effects such as nausea and vomiting were recorded.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
DOUBLE
Enrollment
120
Ultrasound-guided parasternal block was performed with local anesthetic before surgical incision.
Local anesthetic infiltration was performed at the surgical wound site before surgical incision.
Ataturk University
Erzurum, Turkey (Türkiye)
Change in Salivary Opiorphin Level
Salivary opiorphin levels were measured using ELISA to evaluate the analgesic effect of the study interventions.
Time frame: Baseline, 3 minutes after sternotomy, and postoperative 6 hours
Postoperative Pain Intensity Assessed by the Visual Analogue Scale
Postoperative pain intensity was assessed using the Visual Analogue Scale. The scale ranges from 0 to 10, where 0 indicates no pain and 10 indicates the worst imaginable pain. Higher scores indicate worse postoperative pain.
Time frame: At 1, 2, 4, 8, 12, and 24 hours after extubation
Additional Analgesic Requirement
The need for rescue analgesia was recorded during the postoperative follow-up period.
Time frame: Within the first 24 hours after extubation
Total Opioid Consumption
Total opioid consumption delivered by patient-controlled analgesia was recorded.
Time frame: Within the first 24 postoperative hours
Extubation Time
Time to extubation was defined as the duration from the end of surgery to tracheal extubation and was recorded in minutes.
Time frame: Immediately after surgery until tracheal extubation, assessed up to 24 hours postoperatively
Intensive Care Unit Length of Stay
Intensive care unit length of stay was defined as the duration from admission to the intensive care unit after surgery until discharge from the intensive care unit and was recorded in hours.
Time frame: From postoperative intensive care unit admission until intensive care unit discharge, assessed up to 7 days postoperatively
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Postoperative Nausea and Vomiting
Postoperative nausea and vomiting were recorded as adverse effects.
Time frame: Within the first 24 postoperative hours