Pain, Postoperative, Respiratory Complication
Conditions
Keywords
Thoracic epidural analgesia, erector spinae plane block, heart surgery
Brief summary
Postoperative pain negatively effects respiratory functions in open heart surgeries. The aim of the study is to compare the effects of thoracic epidural analgesia (TEA) and erector spinae plane block (ESPB) on postoperative pain and respiratory functions in patients undergoing open heart surgery with sternotomy
Detailed description
Thoracic epidural catheter was inserted to patients in Group T at the T4-T5 vertebra level before induction of general anesthesia. And then local anesthetic infusion was started until postoperative 48. hours. Bilateral erector spinae plan block was applied with total 40 ml of local anesthetic solution to patients in Group E at the T4-T5 vertebra level before induction of general anesthesia. The control group was infused with 1 mcg/kg/min fentanyl during the surgery. In the postoperative period, 1 g paracetamol was infused 4 times a day. All patients underwent general anesthesia with the same method and medications. Tramadol/diclofenac was administered to patients with a pain score (NRS) above 4. NRS and tidal volumes (TV) of the patients were measured at 0, 2, 6, 12, 24, 36 and 48. hours after extubation. Postoperative mechanical ventilation durations, intensive care unit and hospital stays, additional analgesic needs and respiratory complications of the patients were recorded.
Interventions
PROCEDUREThoracic epidural analgesia
Thoracic epidural analgesia was started preoperatively and rest posoperative 48 hours
PROCEDUREErector spinae plane block
Erector spinae plane block was applied preoperatively using local anesthetic
Sponsors
Karadeniz Technical University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
DOUBLE (Subject, Outcomes Assessor)
Masking description
Participants did not know which method was applied to them. Those who evaluated the research results did not know the groups
Intervention model description
The effects of thoracic epidural analgesia and erector spinae plane block on postoperative pain were compared with the control group.
Eligibility
Sex/Gender
ALL
Age
20 Years to 75 Years
Healthy volunteers
Yes
Inclusion criteria
* Has ASA II-IV score * Having open heart surgery
Exclusion criteria
* Having a psychiatric illness * Using analgesic medication due to chronic pain * Uncooperative
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Postoperative pain | Postoperative 48 hours | Patients were asked about their pain levels. Rating done with VRS (Verbal Rating Scale). Pain levels were evaluated between 0 and 10 points. 0: No pain (the best)….. 10: Unbearable pain (the worst) |
| Respiratory functions | Postoperative 48 hours | Oxygen requirement:If more than 4 l/min oxygen support via face mask is required to maintain peripheral oxygen saturation (SpO2) above 90%, it is defined as oxygen requirement. Tachypnea:more than 20/min Fever: more than 37 C celcius Non invasive mechanical ventilation requirement:To patients whose breathing is impaired after extubation (who have tachypnea and have SpO2 less than 90% despite receiving oxygen support of more than 4 l/min oxygen support via face mask) |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Analgesic requirement. When the VRS was more than 4 points | Postoperative 48 hours | diclofenac (75 mg), tramadol (50mg) |
| Intensive care and hospital stay | postoperative 30 days | time for Intensive care and hospital (hours and days, respectively) |
Countries
Turkey (Türkiye)
Outcome results
None listed