Effects of TTPB vs PIFB on Opioid Consumption in Patients After Cardiac Surgery.

Comparison of Effects of Transversus Thoracic Muscle Plane Block vs Pecto-intercostal Fascial Block on Postoperative Opioid Consumption in Patients Undergoing Open Cardiac Surgery: A Prospective Randomized Study

Status

UNKNOWN

Phases

Study type

Interventional

Source

ClinicalTrials.gov

Registry ID

NCT05627869

Enrollment

Registered

2022-11-28

Start date

2023-02-01

Completion date

2023-07-31

Last updated

2023-07-11

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Pain, Postoperative

Keywords

TTPB, PIFB

Brief summary

The objective of this study is to compare the effects of TTPB vs PIFB on postoperative opioid consumption in patients undergoing open cardiac surgery.

Detailed description

Cardiac surgery performed through median sternotomy is associated with significant postoperative pain.Poststernotomy pain leads to decreased patient satisfaction, delirium, cardiovascular complications (hypertension, tachycardia, arrhythmias), hyperglycemia and respiratory complications (bronchial secretion stasis, atelectasis and pneumonia).High-dose opioids can provide good postoperative analgesia for patients undergoing heart surgery. However, opioids have some side effects.The advent of ultrasound-guided regional anaesthesia led to the development of fascial plane chest wall block as transthoracic plane block and pectointercostal fascial block.

Interventions

PROCEDURETransversus thoracic plane block

TTPB group will receive bilateral ultrasound-guided transversus thoracic muscle plane block using 20 ml of bupivacaine 0.25% for each side.

PROCEDUREPecto intercostal fascial block

PIFB group will receive bilateral ultrasound-guided Pecto-intercostal fascial plane block using 20 ml of bupivacaine 0.25% for each side.

Study design

Allocation

RANDOMIZED

Intervention model

PARALLEL

Primary purpose

TREATMENT

Masking

SINGLE (Subject)

Eligibility

Sex/Gender

ALL

Age

18 Years to 75 Years

Healthy volunteers

Inclusion criteria

1. Age between 18 and 75 years. 2. Patient scheduled to undergo elective on-pump cardiac surgery with sternotomy. 3. American Society of Anesthesiologists classification of physical status \< IV.

Exclusion criteria

1. Emergency surgery. 2. Off-pump surgery. 3. Redo surgery. 4. Ejection fraction less than 35%. 5. Refusal of the patient. 6. Known hypersensitivity to LA. 7. Chronic opioid use or chronic pain patient. 8. Psychiatric problems or communication difficulties. 9. Liver insufficiency (defined as a serum bilirubin ≥ 34 μmol/l, albumin ≤ 35 g/dl, INR ≥ 1.7) 10. Renal insufficiency (defined as a glomerular filtration rate \< 44 ml/min). 11. Obstructive sleep apnea syndrome. 12. Coexisting hematologic disorders. 13. Pregnancy or breastfeeding.

Design outcomes

Primary

Measure	Time frame	Description
The primary outcome will be total morphine consumption	24 hours	Total morphine consumption within 24 hours according Visual Analogue Score (VAS) for sternal pain both during rest and with cough (ranging from 0 indicating no pain to 10 indicating extreme pain). A score ≤ 3 was considered acceptable for pain relief. Supplementary rescue analgesia was administered in the form of morphine IV 0.05 mg/kg (at VAS ≥ 4).

Secondary

Measure	Time frame	Description
The secondary outcomes will be the first analgesic request time	24 hours	Is the time to ask for the first postoperative analgesia (morphine), and will be calculated from extubation to patient reporting Visual Analogue Score (VAS) ≥ 4.

Countries

Egypt

Contacts

Primary ContactMariana A Mansour, lecturer

mrmrsyk4@gmail.com01222960009

Outcome results

None listed

Source: ClinicalTrials.gov · Data processed: Feb 7, 2026