Acute Pain, Analgesia, Cardiac Disease, Postoperative Pain
Conditions
Brief summary
This study examine the effect of Parasternal Intercostal Nerve Blocks with local anesthetic on pain control in patients undergoing non-emergent cardiac surgery in a prospective controlled trial. Half of participants will receive General Anesthesia combined to parasternal block while the other half receive only General Anesthesia.
Detailed description
60 patients undergoing elective cardiac surgery will be enrolled and divided into two groups: 1. Interventional (parasternal group) 2. Case control group The parasternal group of patients will receive the pre-operative parasternal block (20 ml of 0.5% Ropivacaine per side) in association with infiltration with local anesthetic of access to thoracic drainage (drainage infiltration with 20 ml of 0.25% Ropivacaine) at the end of the intervention combined to General Anesthesia. The case control group will only receive drainage infiltration with local anesthetic and standard intraoperative management with opioids.
Interventions
PROCEDUREParasternal Block+ Infiltration with local anesthetic of access to thoracic drainage
After induction of general anesthesia we will perform an ultrasound-guided Parasternal Block in association with infiltration with local anesthetic of access to thoracic drainage at the end of the intervention.
PROCEDUREInfiltration with local anesthetic of access to thoracic drainage
Infiltration with local anesthetic of access to thoracic drainage at the end of the intervention.
Sponsors
Campus Bio-Medico University
Study design
Allocation
NON_RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Patients undergoing elective cardiac surgery * Age over 18 years * ASA I-IV * Approval by the patient of informed consent
Exclusion criteria
* Allergy to local anesthetics * Puncture site infection * Lack of signing of informed consent * Weight \<30 Kg * Age \<18 years * Emergency interventions * ASA \> IV * Sternal dehiscences * Dementia (for difficulties in managing weaning from mechanical ventilation and pain)
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Maximum Pain Score | 24 hours | Postoperative pain assessment using the NRS scale (score from 0 to 10) |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Respiratory performance at the TRI-FLOW | 24 hours | Respiratory performance is assessed by the number of balls raised during inspiration with the TRI-FLOW |
| Intraoperative opioid administration | 4 hours | Quantitative evaluation of opioids needed in the intraoperative period |
| Total opioids consumption | 24 hours | Number of opioid deliveries (bolus morphine) in the postoperative period |
| Time to first opioid | 48 hours | The time in minutes between awakening and the first opioid administration |
Countries
Italy
Outcome results
None listed