Cardiac Surgery, Postoperative Pain, Regional Anesthesia Morbidity
Conditions
Keywords
erector spinae plane block, combined serratus anterior plane block, sternotomy
Brief summary
Even though Erector Spinae Plane (ESP) Block is shown to be efficient in cardiac surgery, the Combine Serratus Anterior Plane (CSAP) Block is still controversial if it has an efficient analgesic effect for sternotomy and drain tube pain relief. This study aims to compare ESP block and CSAP block for postoperative analgesia in coronary bypass surgery patients.
Detailed description
Acute postoperative pain after cardiac surgery originates various surgical procedures that may cause pain including the incision of tissues, sternotomy, the separation of bone-joint structures, the severity and duration of these applications, the use of chest tubes, and the patient's personal inflammatory may affect the response to these stimuli. Postoperative pain is a critical risk factor for the development of pulmonary and cardiovascular complications such as atelectasis, cardiac ischemia, and arrhythmias. Researchers claim that adding techniques to iv drugs, such as thoracic epidural anesthesia, paravertebral block, or erector spinae plane block (ESP) to multimodal analgesia regimens positively affect recovery. Although the efficacy of ESP block in providing postoperative analgesia has been demonstrated in many studies, there is no study comparing CSAP and ESP block in cardiac surgery.
Interventions
PROCEDUREESP block
Preoperative, awake, bilateral, ultrasound-guided erector spinae plane block with 30 mL 0.25 % bupivacaine
PROCEDURECASP block
Preoperative, awake, bilateral, ultrasound-guided combine serratus anterior plane block with 30 mL 0.25 % bupivacaine
Sponsors
Ankara City Hospital Bilkent
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
SUPPORTIVE_CARE
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to 65 Years
Healthy volunteers
No
Inclusion criteria
* Adult patients who will undergo coronary artery bypass grafting surgery with median sternotomy
Exclusion criteria
* Emergency surgeries * Patients with allergic reactions to anesthesia and analgesia drugs to be used * Patients who do not want to participate in the study voluntarily * Severe systemic disease (kidney, liver, pulmonary, endocrine) * Substance abuse history * History of chronic pain * Psychiatric problems and communication difficulties * Patients who need revision due to hemostasis in the postoperative period * Patients with severe hemodynamic instability due to infection, heavy bleeding, etc.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Postoperative 4 hour measurement | 4 hour after ICU admission, an average of 5 minutes | patients will be evaluated in terms of the visual analog pain scale, the scale has a range of 0 to 10. The scale will be shown to patients and 0 means the patient has no pain, 10 means the patient feels the most pain ever felt. |
| Postoperative 12 hour measurement | 12 hour after ICU admission, an average of 5 minutes | patients will be evaluated in terms of the visual analog pain scale, the scale has a range of 0 to 10. The scale will be shown to patients and 0 means the patient has no pain, 10 means the patient feels the most pain ever felt. |
| Postoperative 24 hour measurement | 24 hour after ICU admission, an average of 5 minutes | patients will be evaluated in terms of the visual analog pain scale, the scale has a range of 0 to 10. The scale will be shown to patients and 0 means the patient has no pain, 10 means the patient feels the most pain ever felt. |
| Postoperative 2 hour measurement | 2 hour after ICU admission, an average of 5 minutes | patients will be evaluated in terms of the visual analog pain scale, the scale has a range of 0 to 10. The scale will be shown to patients and 0 means the patient has no pain, 10 means the patient feels the most pain ever felt. |
| Postoperative 6 hour measurement | 6 hour after ICU admission, an average of 5 minutes | patients will be evaluated in terms of the visual analog pain scale, the scale has a range of 0 to 10. The scale will be shown to patients and 0 means the patient has no pain, 10 means the patient feels the most pain ever felt. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Intensive care unit duration | postoperative, approximately 12 to 36 hours | The total time until patients suitable for discharge from intensive care unit |
| Mechanical ventilation duration | postoperative, approximately 4 to 10 hours | he total time until patients suitable for endotracheal extubation |
Countries
Turkey (Türkiye)
Outcome results
None listed