Cardiovascular Surgery, Postoperative Analgesia, Regional Anaesthesia
Conditions
Keywords
cardiovascular surgery, pectoral-intercostal fascial plane block, recto-intercostal fascial plane block, rectus sheath block, postoperative analgesia
Brief summary
The aim of the present study is to evaluate the effects of the recto-intercostal fascial plane block (RIFPB) or the rectus sheath block (RSB) combined with the pectoral-intercostal fascial plane block (PIFPB) on postoperative analgesia in patients undergoing cardiac surgery.
Detailed description
Effective pain management after cardiac surgery is crucial in improving patient outcomes, promoting early postoperative mobilisation and minimising the risk of postoperative respiratory complications. It has indeed been shown that these patients experience moderate to severe pain during the postoperative period. While opioids are commonly used in perioperative care, they are also linked to adverse opioid-related effects. The literature suggests selecting an analgesic treatment strategy that avoids opioid-based analgesia for patients undergoing cardiac surgery during the postoperative period. Regional anaesthesia techniques are widely used in cardiac surgery patients to address concerns about the risk of myocardial and/or renal damage associated with non-steroidal anti-inflammatory drugs (NSAIDs), reduce the incidence of potential opioid-related side effects, lower the high risk of delirium and improve patient rehabilitation. However, only a limited number of studies have demonstrated the effects of the recto-intercostal fascial plane block (RIFPB) or the rectus sheath block (RSB) combined with the pectoral-intercostal fascial plane block (PIFPB) on postoperative analgesia in cardiac surgery patients. Therefore, the present study aims to evaluate the effects of the RIFPB or the RSB combined with the PIFPB on postoperative analgesia in patients undergoing cardiac surgery.
Interventions
OTHERPIFPB + RIFPB
The procedure is performed under ultrasound guidance in a separate regional anaesthesia room during the preoperative period, under standard ASA monitoring.
OTHERPIFPB + RSB
The procedure is performed under ultrasound guidance in a separate regional anaesthesia room during the preoperative period, under standard ASA monitoring.
OTHERControl
Regional anesthesia is not applied.
Sponsors
Antalya Health Sciences University
Study design
Observational model
CASE_ONLY
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* elective cardiac surgery planned * over 18 years, adult * American Society of Anaesthesiology (ASA) score I-III
Exclusion criteria
* under 18 years of age, * ASA IV and above, * contraindications for the block application * history of cardiac surgery, * reoperated due to surgery-related complications after emergency surgery or postoperative elective surgery, * off-pump cardiac surgery or minimally invasive cardiac surgery * unable to be extubated in the intensive care unit at 24 hours postoperatively * history of chronic pain treatment * chronic alcoholism and substance abuse * declining to give written informed consent
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| postoperative opioid consumption | 48 hours |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| postoperative recovery quality | 24 hours | TThe Quality of Recovery-15 (QoR-15) is a 15-question questionnaire validated to assess poetoperative recovery. This questionnaire assesses patients' pain, physical comfort, physical independence, psychological support, and emotional status in the erly postoperative period. The patient is asked to express their status scoring from 0 to 10; therefore, the total score ranges from 0 to 150 points. |
| postoperative pain scores | 48 hours | The NRS score (0=no pain; 10=most severe pain) will be used to assess postoperative pain |
| chronic pain | 3 months | Patients will be telephoned 3 months after the operation and the presence, localization, and intensity of the pain, its character, and its relation with rest and/or activity will be recorded by asking only verbally. The NRS score (0=no pain; 10=most severe pain) will be used to assess postoperative pain. |
Countries
Turkey (Türkiye)
Contacts
CONTACTArzu Karaveli
PRINCIPAL_INVESTIGATORArzu Karaveli
University of Health Sciences, Antalya Training and Research Hospital
PRINCIPAL_INVESTIGATORCeren Nida Kural
University of Health Sciences, Antalya Training and Research Hospital
Outcome results
None listed