Combination of Parasternal and Serratus Anterior Plane Block in Coronary Artery Bypass Graft Surgery

Not Applicable

Completed

• Conditions: Parasternal Block; Acute Pain; Serratus Anterior Plane Block; Postoperative Analgesia; Cardiac Surgery
• Interventions: Procedure: Combined parasternal block and serratus anterior plane block

• Registration Number: NCT06326333
• Lead Sponsor: Ankara City Hospital Bilkent

Brief Summary

Postoperative analgesia is a critical risk factor for the development of pulmonary and cardiovascular complications in coronary artery bypass graft (CABG) surgery. If patients with high pain levels cannot breathe effectively, it may lead to atelectasis, cardiac ischemia, and arrhythmias. This prolongs the time it takes for patients to be discharged and increases the frequency of postoperative pulmonary complications and postoperative morbidity.

In addition to intravenous medications, various neuraxial and peripheral nerve blocks can be used in cardiac surgery. In recent years, neuraxial anesthesia has been avoided due to the use of intraoperative high-dose heparin. As an alternative, peripheral nerve blocks have recently gained popularity. Parasternal block (PSB) and serratus anterior plane block (SAPB) are very superficial and easy to reach. Recently, in the literature, the number of cases performed with these blocks under ultrasound guidance and the number of randomized controlled prospective studies have increased.

With this study, it was aimed to observe the analgesic effects on both the sternum and the drain site by applying PSB and SAPB applications simultaneously in the postoperative analgesia of CABG patients.

Detailed Description

Not available

Study Timeline

• Study Start: 2024-02-07
• Study First Submitted: 2024-03-17
• Study First Submitted QC: 2024-03-17
• Study First Posted: 2024-03-22
• Primary Completion: 2024-03-27
• Status Verified: 2024-04
• Study Completion: 2024-04-18
• Last Update Submitted: 2024-04-19
• Last Update Posted: 2024-04-22

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 20

Inclusion Criteria

• 18 to 80 years old
• American Society of Anesthesiologists (ASA) physical status I-II-III
• BMI 18 to 30 kg/m2
• Elective coronary artery bypass graft (CABG) surgery

Exclusion Criteria

• Patient refusing the procedure
• Emergency surgery
• History of chronic opioid or analgesic used

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: SINGLE_GROUP

Arm && Interventions

Group	Intervention	Description
Combined parasternal block and serratus anterior plane block	Combined parasternal block and serratus anterior plane block	In the parasternal block application, the needle will be advanced under the pectoralis major muscle and above the intercostal muscle with the ultrasound-guided in-plane technique. 7.5 ml of 0.25% bupivacaine will be injected into this area per each level, at the level of the second and fourth intercostal space. Then, in the serratus anterior plane block application, in the anterior axillary line, the needle will be advanced under the serratus anterior muscle, above the sixth rib, with the in-plane technique under ultrasound guidance. 10 ml of 0.25% bupivacaine will be injected into this area. The application will be applied bilaterally.

Primary Outcome Measures

Name	Time	Method
Pain Scores	12th hour of the extubation	After the extubation, pain will be assessed for the sternum and the drain area at the 12th-hour rest and while coughing using the visual analog scale on a scale from 0 (no pain) to 10 (worst pain).

Secondary Outcome Measures

Name	Time	Method
Remifentanyl Consumption	intraoperative period	Remifentanyl consumption for intraoperative period will be recorded

Trial Locations

Locations (1)

Ankara City Hospital; 🇹🇷 Çankaya, Ankara, Turkey