Postoperative Analgesia
Conditions
Interventions
Intervention group: Liposomal bupivacaine 266 mg (20 mL diluted to a total injectable volume of 50 mL) was administered as a combined bilateral superficial parasternal intercostal fascial infiltration
Control group:Control group: Normal saline 50 mL was administered using the identical infiltration technique (bilateral parasternal intercostal fascial and rectus sheath sites) at the same procedural
Sponsors
Beijing Anzhen Hospital, Capital Medical University
Eligibility
Sex/Gender
All
Age
18 Years to 70 Years
Inclusion criteria
Inclusion criteria: 1. Diagnosis of type A aortic dissection (TAAD) confirmed by contrast-enhanced computed tomography (CT), in accordance with the 2022 ACC/AHA Guideline for the Diagnosis and Management of Aortic Disease; 2. Age 18–70 years, BMI 18.5–35 kg/m²; GERAADA score <=4; 3. Scheduled for total aortic arch replacement under cardiopulmonary bypass (CPB); 4. Ability to comprehend and assess Visual Analog Scale (VAS) scores and operate an intravenous patient-controlled analgesia (PCA) pump; 5. Provision of written informed consent and willingness to complete follow-up.
Exclusion criteria
Exclusion criteria: 1. Intraoperative conversion to hemiarch replacement or debranching procedures; 2. Redo sternotomy; 3. Pregnancy, lactation, or planned conception during the study period; 4. Active systemic or cardiopulmonary infection; 5. Severe coagulopathy or bleeding tendency; 6. Preoperative requirement for mechanical ventilation; 7. Use of mechanical circulatory support devices; 8. Contraindications or hypersensitivity to local anesthetics; 9. Chronic pain history (>3 months); 10. Preoperative opioid use =15 mg morphine equivalents/day for =15 days within 30 days prior to surgery; 11. Clinically significant neurological deficits (e.g., spinal cord injury, paralysis, or neurological impairment in the block area); 12. Severe renal/hepatic dysfunction (serum creatinine >2 mg/dL [176.8 µmol/L], blood urea nitrogen >50 mg/dL [17.9 mmol/L], aspartate aminotransferase [AST] or alanine aminotransferase [ALT] >3× upper limit of normal); 13. Neurological/psychiatric disorders interfering with postoperative assessments; 14. Concurrent participation in other clinical trials; 15. Other investigator-determined contraindications.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| QoR-15 score; | — |
Secondary
| Measure | Time frame |
|---|---|
| (Overall Benefit of Analgesic Scale,OBAS);Cumulative Analgesic Consumption in Morphine Equivalents;Time to First Rescue Analgesic Requirement Postoperatively; | — |
Countries
China
Contacts
Public ContactSheng Wang, Peirong Lin
Beijing Anzhen Hospital, Capital Medical University
Outcome results
None listed