Postoperative Pain, Coronary Artery Bypass Grafting
Conditions
Keywords
Serratus Anterior Plane Block, PECS II Block, Regional Anesthesia, Opioid-Sparing, Cardiac Surgery
Brief summary
It was aimed to examine the effects of anterior chest wall blocks (PECS and SAP) performed for postoperative analgesia on pain scores assessed using the Visual Analog Scale (VAS), opioid consumption, duration of mechanical ventilation, time to first mobilization, ICU length of stay, postoperative nausea and vomiting (PONV), and block-related complications in adult patients undergoing coronary artery bypass grafting (CABG).
Detailed description
This prospective randomized controlled trial evaluated the postoperative analgesic efficacy of ultrasound-guided serratus anterior plane (SAP) block and PECS II block in adult patients undergoing elective coronary artery bypass grafting (CABG). Eligible patients were randomized into three groups: SAP block, PECS II block, and a control group receiving standard systemic analgesia without regional block. The primary outcome was postoperative pain intensity assessed by Visual Analog Scale (VAS) scores at predefined post-extubation time points. Secondary outcomes included total opioid consumption within the first 24 postoperative hours, postoperative nausea and vomiting (PONV), and block-related complications. Exploratory recovery-related outcomes included mechanical ventilation duration, time to first mobilization, and ICU length of stay. Recovery-related outcomes were analyzed descriptively and considered exploratory because ICU clinicians were not blinded and important perioperative confounders were not systematically collected.
Interventions
PROCEDURESerratus Anterior Plane Block
Ultrasound-guided serratus anterior plane (SAP) block performed with 30 mL of 0.25% bupivacaine.
PROCEDUREPECS II Block
Ultrasound-guided PECS II block performed using a two-injection technique with a total of 30 mL of 0.25% bupivacaine.
Sponsors
Yuzuncu Yil University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Outcomes Assessor)
Masking description
Postoperative outcome assessors were blinded to group allocation.
Intervention model description
Prospective randomized controlled trial
Eligibility
Sex/Gender
ALL
Age
20 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Adult patients aged 20 years and older * ASA physical status II-IV * Scheduled for elective coronary artery bypass grafting (CABG) * Provided written informed consent
Exclusion criteria
* Refusal to participate * Pregnancy * Presence of bleeding diathesis * Severe hepatic or renal failure
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Postoperative pain intensity assessed using the Visual Analog Scale (VAS) | 4, 8, 12, and 24 hours after extubation | Pain intensity will be assessed using the Visual Analog Scale (VAS). The VAS is a 10-centimeter scale where 0 cm = "no pain" and 10 cm = "worst imaginable pain"; higher scores indicate worse pain intensity. Assessments will be performed at 4, 8, 12, and 24 hours after extubation. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Postoperative nausea and vomiting (PONV) and block-related complications | Within 24 hours after surgery | Postoperative adverse events including nausea, vomiting, and block-related complications will be recorded. |
| Exploratory ICU length of stay | From ICU admission until ICU discharge, assessed up to 30 days | Length of stay in the intensive care unit measured in hours from ICU admission |
| Exploratory time to first mobilization | From ICU admission until first mobilization, assessed up to 7 days | Time from ICU admission to first mobilization measured in hours |
| Exploratory mechanical ventilation duration | From ICU admission until successful extubation, assessed up to 7 days | Time from ICU admission to successful extubation |
| Total opioid consumption within the first 24 postoperative hours | Cumulative opioid consumption assessed during the first 24 postoperative hours | Total postoperative opioid consumption will be recorded as cumulative tramadol and pethidine doses administered within the first 24 postoperative hours and converted to intravenous morphine equivalents. |
Countries
Turkey (Türkiye)
Contacts
STUDY_CHAIRSchool of Mdicine Department of Anesthesiology and Reanimation
Yuzuncu Yil University
Outcome results
None listed