Postoperative Pain
Conditions
Brief summary
In this study the investigators will investigate the efficacy of ESPB as a part of Enhanced recovery after surgery on postoperative analgesia and recovery criteria after off pump cardiac surgery.
Detailed description
General anaesthesia will be induced by 0.05 mg/kg midazolam, 3 µg/kg fentanyl, 1-2mg/kg propofol, and 0.5mg/kg of Atracurium. After induction, bilateral erector spinae plane block will be performed in the block group. Intraoperative analgesia will be achieved by fentanyl boluses of 0.5-to-1 µg/kg titrated according to haemodynamic parameters. Postoperative analgesia will be managed by paracetamol 1000 mg /6hours and morphine 1-2mg boluses when pain score ≥4 1 to 2 mg to be repeated every 5 minutes if needed.
Interventions
PROCEDUREErector spinae block
After induction, the patients will be administered bilateral Erector spinae block with 20 ml of 0.25 % bupivacaine
DRUGFentanyl
fentanyl boluses of 0.5-to-1 µg/kg titrated according to haemodynamic parameters.
Sponsors
Menoufia University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
OTHER
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to 70 Years
Healthy volunteers
No
Inclusion criteria
* age 18-70 years * ejection fraction of \> 45% * undergoing elective off-pump cardiopulmonary bypass surgery
Exclusion criteria
* vertebral anomalies * intra-aortic balloon pump in the preoperative period * acute myocardial infarction * local infection at the site of block * allergy to the local anesthetic used * morbid obesity, psychiatric disorders, neurologic deficits, alcohol and chronic opioid abuse, and patients with bleeding diathesis.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Total intraoperative and postoperative opioid consumption | 48 hours | Microgram and mg |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| mean arterial blood pressure | 48 hours | mmHg |
| pain intensity at rest and movement | 48 hours | numerical rating score from zero to ten ( 0=no pain, 10 =severe pain ) |
| time to first rescue analgesia | 24hous | minutes |
| Duration of mechanical ventilation | 24 hours | hours |
| The heart rate | 48 hours | Beats per minutes |
| time to ambulation | 24hours | hours |
| time to oral intake | 48 hours | hours |
| time of chest drain removal | 5 days | hours |
| time of intensive care unit stay | one week | hours |
| time to extubation | 24hours | min |
Countries
Egypt
Outcome results
None listed