Postoperative pain in cardiac surgery Postoperative pain in cardiac surgery, parasternal block
Conditions
Interventions
Parasternal block at 2nd/3rd and 4th/5th bilaterally, 0.5% Ropivacaine 5 ml each injection site.
Intraoperative intravenous fentanyl adjusted by hemodynamic responses.
Postoperative PCA fentanyl 10 mc
Experimental Procedure/Surgery,No Intervention No treatment
parasternal block,control
Sponsors
None listed
Eligibility
Sex/Gender
All
Age
18 Years to 65 Years
Inclusion criteria
Inclusion criteria: 1. Age 18 - 65 years old undergoing cardiac surgery with median sternotomy at King Chulalongkorn Memorial Hospital, 2. Able to provide informed consent independently, 3. ASA (American Society of Anesthesiologists) class 1-3, 4. BMI 18-35 Kg/m2, 5. Extubation must be performed within 6 hours postoperatively
Exclusion criteria
Exclusion criteria: 1. Resternotomy, 2. Contraindication for parasternal block such as infection at parasternal area, preexisting coagulopathy, local anesthetic drugs allergy, 3. left ventricular ejection fraction below 30%, 4. intra aortic balloon pump or ECMO insertion, 5. non cooperate patients such as severe dementia, mental retard, 6. susceptibility for local anesthetic toxicity such as BMI under 18 Kg per m2, chronic liver disease, serum albumin level below 2.8 g per dL, 7. estimated GFR below 45 ml per min per 1.73m2, 8. chronic pain using daily opioids more than 3 months or morphine dose over than 60 mg per day more than 1 month, 9. diagnosed neuropathic pain or using gabapentinoid or tricyclic antidepressant, 10. reoperation within 24 hours
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| total fentanyl consumption intraoperative to 24 hours postoperative 24 hours postoperative microgram | — |
Secondary
| Measure | Time frame |
|---|---|
| Pain score 0, 4, 8, 12, 24 hours postoperative numeric rating scale,time to extubate extubation minutes,ICU stay discharge from ICU hours,incidence of opioid side effects 24 hours postoperative events,incidence of parasternal block complication 24 hours postoperative events,incidence of sternal/rib fracture 24 hours postoperative events,incidence of neuropathic pain 4, 8, 12 weeks postoperative events | — |
Countries
Thailand
Contacts
Public ContactMutita Chaichalothorn
King Chulalongkorn Memorial Hospital
Outcome results
None listed