Coronary Artery Bypass, Anesthesia, Conduction, Nerve Block, Pain, Postoperative
Conditions
Keywords
Transversus thoracic muscle plane block, postopertive pain, sternotomy
Brief summary
In this prospective and controlled study, the investigators investigated the effect of transversus thoracic muscle plane block (TTMP) on analgesia in patients who undergo coronary artery bypass graft (CABG) surgery with median sternotomy. For this purpose, the investigators aimed to compare the hemodynamic responses to surgical incision and sternotomy and, pain intensity, total analgesic consumption, additional analgesic requirements of the patients in the first 24 hours after extubation under postoperative patient-controlled analgesia (PCA) adminisration.
Detailed description
Forty-six patients aged 18-70 years, ASA class I-III, who undergo CABG surgery were included in our study. The patients were randomized into the TTKPB group and the control group. Heart rate (HR) and mean arterial pressure (MAP) were recorded before peroperative induction, before skin incision, after skin incision, before sternotomy and after sternotomy. PCA with tramadol was applied after extubation and Numeric rating scale NRS scores, total tramadol consumption, number of requests and additional analgesic requirements were recorded at 0, 1, 2, 4, 8, 12 and 24 hours.
Interventions
Transversus thoracic muscle plane block is a single-shot nerve block technique that provides analgesia for the anterior chest wall Tramadol IV PCA (Patient Controlled Analgesia): Basal infusion 0.2 mg/kg/h, bolus 20 mg, lock time 20 minutes
DRUGTramadol
Tramadol IV PCA (Patient Controlled Analgesia): Basal infusion 0.2 mg/kg/h, bolus 20 mg, lock time 20 minutes
Sponsors
Istanbul University - Cerrahpasa
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
DOUBLE (Subject, Caregiver)
Eligibility
Sex/Gender
ALL
Age
18 Years to 70 Years
Healthy volunteers
No
Inclusion criteria
* ASA (American Society of Anesthesiologists) classification I-III * Coronary artery bypass graft operation with median sternotomy under elective conditions
Exclusion criteria
* Refusing to participate in the study * Under 18 and over 70 * ASA class IV and above * EF (Ejection Fraction) \< 40% * Emergency surgery or reoperation * Intraaortic balloon pump placement * Known allergy to local anesthetics * Coagulation disorder * Infection at the block site * History of sternotomy * Those with chronic pain complaints and long-term use of analgesics * Patients who could not be extubated within 12 hours after the operation
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Mean arterial pressure | Postoperative 24 hours | Postoperative 0, 1, 2, 4, 8, 12 and 24 hours |
| Heart rate | Postoperative 24 hours | Postoperative 0, 1, 2, 4, 8, 12 and 24 hours |
| Numeric Rating Scale (NRS) at rest | Postoperative 24 hours | Numeric Rating Scale (NRS) for postoperative pain |
| Numeric Rating Scale (NRS) during coughing | Postoperative 24 hours | Numeric Rating Scale (NRS) for postoperative pain |
| Bispectral Index (BIS) | Peroperative | Peroperative induction, before skin incision, after skin incision, before sternotomy and after sternotomy. |
Countries
Turkey (Türkiye)
Outcome results
None listed