Postoperative Pain, Chest Pain, Coronary Artery Bypass, Sternotomy
Conditions
Keywords
adult cardiac surgery, poststernotomy pain, transversus thoracic muscle plane block, parasternal intercostal block, behavioral pain scale, numeric rating scale
Brief summary
Inadequate pain control after coronary artery bypass graft surgery increases mortality and results in a higher incidence of persistent poststernotomy pain syndrome. Our aim is to assess whether ultrasound-guided parasternal intercostal block (PSIB) or surgeon implied transversus thoracic muscle plane block (TTMPB) would improve the postoperative pain scores and decrease tramadol consumption better after coronary artery bypass graft surgery
Interventions
40 ml %0.375 bupivacaine divided into 4 equal doses will be injected by the surgeon between internal intercostal muscle and transversus thoracis muscle at the 2nd and 3rd intercostal space and 4th and 5th intercostal space
PROCEDUREParasternal Intercostal Plane Block
40 ml %0.375 bupivacaine injection will be performed by ultrasound guidance after completion of surgery between pectoralis major muscle and external intercostal muscle at the 2nd and 3rd intercostal space and 4th and 5th intercostal space bilaterally by anesthesiologist.
Sponsors
Muğla Sıtkı Koçman University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
TRIPLE (Subject, Caregiver, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
45 Years to 80 Years
Healthy volunteers
No
Inclusion criteria
* American Society of Anesthesiologists physical status II-III * Elective coronary artery bypass graft surgery under general anesthesia
Exclusion criteria
* American Society of Anesthesiologists physical status IV * Emergency surgery and redo surgery * Low cardiac output syndrome, perioperative intra-aortic balloon pump support for any reason, bleeding disorder or abnormal coagulation profile, abnormal hepatic and renal parameters, uncontrolled diabetes mellitus, chronic obstructive pulmonary disease, atrial fibrillation on anticoagulation * Allergy to any study drugs, local infection at the block site * Opioid abuse
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Postoperative opioid consumption | Postoperative 24th hour | Tramadol consumption will be assessed by checking patient daily drug order records |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Behavioral Pain Scale | postoperative 1st and 4th hour | A blinded nurse will assess postoperative pain while they are intubated at the 1st and 4th hour by using 3 subscale Behavioral Pain Scale which ranges from 3 (no pain) to 12 (maximum pain) |
| Numeric Rating Scale | Postoperative 12th and 24th hour | A blinded nurse will assess postoperative pain during resting and movement at postoperative 12th and 24th hour by using Numeric rating scale at the extubated patient by using 11-point Numerical Rating Scale which ranges from '0' (means no pain) to '10' (means worst pain imaginable) |
Countries
Turkey (Türkiye)
Outcome results
None listed