Transversus Thoracis Muscle Plane Block for Postoperative Pain in Adult Cardiac Surgery

Not Applicable

Completed

• Conditions: Postoperative Pain; Chest Pain; Coronary Artery Bypass; Sternotomy
• Interventions: Procedure: Transversus Thoracic Muscle Plane Block; Procedure: Parasternal Intercostal Plane Block

• Registration Number: NCT04591119
• Lead Sponsor: Muğla Sıtkı Koçman University

Brief Summary

Inadequate pain control after coronary artery bypass graft surgery increases mortality and results in a higher incidence of persistent poststernotomy pain syndrome. Our aim is to assess whether ultrasound-guided parasternal intercostal block (PSIB) or surgeon implied transversus thoracic muscle plane block (TTMPB) would improve the postoperative pain scores and decrease tramadol consumption better after coronary artery bypass graft surgery

Detailed Description

Not available

Study Timeline

• Study First Submitted: 2020-10-11
• Study First Submitted QC: 2020-10-11
• Study First Posted: 2020-10-19
• Study Start: 2020-10-20
• Primary Completion: 2020-12-20
• Study Completion: 2020-12-21
• Status Verified: 2023-11
• Last Update Submitted: 2023-11-29
• Last Update Posted: 2023-12-05

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 75

Inclusion Criteria

• American Society of Anesthesiologists physical status II-III
• Elective coronary artery bypass graft surgery under general anesthesia

Exclusion Criteria

• American Society of Anesthesiologists physical status IV
• Emergency surgery and redo surgery
• Low cardiac output syndrome, perioperative intra-aortic balloon pump support for any reason, bleeding disorder or abnormal coagulation profile, abnormal hepatic and renal parameters, uncontrolled diabetes mellitus, chronic obstructive pulmonary disease, atrial fibrillation on anticoagulation
• Allergy to any study drugs, local infection at the block site
• Opioid abuse

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Transversus Thoracic Muscle Plane Block (TTMPB) Group	Transversus Thoracic Muscle Plane Block	At the TTMPB group, the block will be performed by the surgeon before the closure of the sternum by visualizing the muscles and identifying them. In the TTMPB group patients will receive 40 ml %0.375 bupivacaine divided into 4 equal doses between internal intercostal muscle and transversus thoracic muscle at the 2nd and 3rd intercostal space and 4th and 5th intercostal space.
Parasternal Intercostal Block (PSIB) Group	Parasternal Intercostal Plane Block	At the PSIB group, the block will be performed by ultrasound guidance after completion of surgery. PSIB Blocks will be performed under ultrasonography guidance using a linear 6 to 13 megahertz ultrasound probe by the anesthesist.In PSIB group patients will receive 40 ml %0.375 bupivacaine divided into 4 equal doses between psoas major muscle and external intercostal muscle at the 2nd and 3rd intercostal space and 4th and 5th intercostal space bilaterally.

Primary Outcome Measures

Name	Time	Method
Postoperative opioid consumption	Postoperative 1st, 4th and 12th hour	Tramadol consumption will be assessed by checking patient daily drug order records

Secondary Outcome Measures

Name	Time	Method
Behavioral Pain Scale	postoperative 1st and 4th hour	A blinded nurse will assess postoperative pain while they are intubated at the 1st and 4th hour by using 3 subscale Behavioral Pain Scale which ranges from 3 (no pain) to 12 (maximum pain)
Numeric Rating Scale	Postoperative 12th and 24th hour	A blinded nurse will assess postoperative pain during resting and movement at postoperative 12th and 24th hour by using Numeric rating scale at the extubated patient by using 11-point Numerical Rating Scale which ranges from '0' (means no pain) to '10' (means worst pain imaginable)

Trial Locations

Locations (1)

Mugla Sıtkı Kocman University Training nad research Hospital; 🇹🇷 Mugla, Turkey