The Effect of Ultrasound-guided Bilateral Single Shot Pecto -Intercostal Plane Block on Recovery After On-pump Coronary Bypass Graft Surgery
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 40
- 试验地点
- 2
- 主要终点
- extubation time
研究概览
简要总结
Fast track and ultrafast track cardiac anaesthesia appear to demonstrate improved outcomes without compromising patient safety. Their benefits include shorter intensive care unit stays, reduced duration of mechanical ventilation and lower health care costs. Regional anesthesia has played an important role in enhanced recovery pathways for other surgical services and allows for reduced systemic opioid use during intraoperative and postoperative care This study will be conducted to evaluate the effectiveness and safety of ultrasound guided bilateral single shot pecto - intercostal plane block on recovery after on pump CABG surgery.
详细描述
Fast-track anesthesia (FTA) is a procedure that enables extubation in intensive care unit (ICU) within 6 h after surgery to facilitate the recovery of consciousness and autonomous breathing. It has been safely applied to cardiac surgery since the 1990s.
FTA is feasible and safe and reduces the occurrence of ventilator induced complications, thereby decreasing ICU stay, resource use and cost.
Ultra-fast tract anesthesia (UFTA) was developed after fast-track anesthesia to further optimize the use of medical resource. With UFTA, extubation is performed immediately or within 1 h after surgery in the operating room. The benefits of UFTA include lower incidence of postoperative complications, better hemodynamic performance, shorter ICU stay.
Fast track and ultrafast track cardiac anaesthesia can be achieved by reduced opioid doses or opioid free with multimodal analgesia augmented with bilateral regional anaesthesia as pecto - intercostal plane block.
Fast track and ultrafast track cardiac anaesthesia appear to demonstrate improved outcomes without compromising patient safety. Their benefits include shorter intensive care unit stays, reduced duration of mechanical ventilation and lower health care costs. Regional anesthesia has played an important role in enhanced recovery pathways for other surgical services and allows for reduced systemic opioid use during intraoperative and postoperative care.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Supportive Care
- 盲法
- Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)
入排标准
- 年龄范围
- 40 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Patient aged more than 40 years old.
- •scheduled for elective open-heart surgery including CABG with on pump cardiopulmonary bypass.
排除标准
- •Patients with severe pulmonary hypertension and / or heart failure.
- •Emergency or combined cardiac surgery.
- •Patients with preoperative use of intra-aortic balloon pump.
- •Patients with poor ventricular function less than 45 %.
- •Patients with preoperative uncontrolled arrhythmia.
- •Patients with moderate to severe hepatic and / or renal dysfunction.
- •Patients with anticipated difficult airway.
- •Severe obstructive and / or restrictive pulmonary function test.
结局指标
主要结局
extubation time
时间窗: up to 7 days postoperative
duration of mechanical ventilation from the end of anaesthesia till fulfillment weaning criteria and extubated
次要结局
- ICU stay duration(up to 7 days postoperative)
- Postoperative mean arterial blood pressure measurement(within 24 hours postoperative)
- Postoperative heart rate measurement(within 24 hours postoperative)
- Postoperative pain measurement by numerical rating scale(within 24 hours postoperative)
研究者
tarek abdel hay mostafa
principle investigator
Tanta University