Opioid Use
Conditions
Keywords
regional anesthesia, intercostal plane block, opioid, open heart surgery
Brief summary
This study aims to assess the impact of bilateral deep parasternal intercostal plane block on intraoperative opioid consumption in open heart surgery
Detailed description
High-dose opioid is associated with various side effects such as nausea, vomiting, urinary retention, and respiratory depression. The neuraxial block (intrathecal, epidural) and peripheral nerve block are regional anesthesia techniques which have the potential to reduce intraoperative opioid consumption. The deep parasternal intercostal plane block is fascial plane block which intended to block anterior cutaneous branch of intercostal nerves. This study is a double-blind randomized controlled trial. Thirty subjects will be recruited with consecutive sampling method. Eligible subjects with signed informed consent will be randomized into two groups. The first group is the treatment group who will receive bilateral deep parasternal intercostal plane block after induction of anesthesia and the second group will be the control group who will not receive any regional anesthesia. After surgery, extubation time, adverse event (nausea, vomiting), and intensive care unit length of stay will be recorded for both groups.
Interventions
Twenty milliliters of 0.25% bupivacaine will be placed bilaterally in the fascial plane between internal intercostal muscle and transversus thoracis muscle at intercostal space 4 or 5, lateral from sternum, with ultrasound guidance using high-frequency linear transducer.
PROCEDUREcontrol
Skin puncture with needle will be performed on the same location as the treatment group without administration of local anesthetics.
Sponsors
Indonesia University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Investigator)
Eligibility
Sex/Gender
ALL
Age
18 Years to 70 Years
Healthy volunteers
Yes
Inclusion criteria
* Age 18-70 years old * Elective open-heart surgery with median sternotomy approach
Exclusion criteria
* Patient who refuses to participate * Patient with local infection in the block area * Patient with chronic pain * Patient with history of chronic analgesics use * Patient who is contraindicated for local anesthetics * Patient with cognitive disorder * Patient with severe psychiatric disorders
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Total intraoperative fentanyl dose | intraoperatively | Total intraoperative fentanyl dose will be calculated after surgery |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| opioid side effects | within 24 hours after surgery | Incidence of nausea and vomiting |
| extubation time | Up to 72 hours after surgery | Investigators will record time to extubation after surgery |
| Time to first intraoperative fentanyl | intraoperatively | Investigators will record time to first fentanyl dose after incision |
| Intensive care unit length of stay | Up to 7 days after surgery | Investigators will record total time from intensive care unit admission until patient transferred to surgical wars |
Countries
Indonesia
Contacts
Primary ContactAida Rosita R Tantri, doctor
Backup ContactA A G Putra Semara, doctor
Outcome results
None listed