Comparison of ultrasound guided pecto intercostal fascial block and transversus thoracic muscle plane block for quality of recovery after cardiac surgery requiring median sternotomy A prospective randomize double blind study

A total of 60 patients posted for elective cardiac surgery requiring median sternotomy will be randomly divided into two equal groups (30 each), group PIFB and group TTMPB. We will compare the effectiveness of ultrasound- Guided Pecto- Intercostal Fascial Block and Transversus Thoracic Muscle Plane Block. Post operatively, pain scores will be recorded at rest and during coughing using 11- point Numeric Rating Scale (NRS) at 0,3,6,12,12, and 24 hours. On assessment, if NRS is 3 or more, first rescue analgesia (iv diclofenac sodium 1mg/kg) will be administered. Patient will be reassessed after 30 minutes; if NRS persists to be 3 or more, a second rescue analgesia (iv tramadol 2mg/kg) will be given. Duration of analgesia will be recorded. Quality of recovery (QoR) will be assessed using Quality of Recovery- 15 (QoR- 15) scale at 24 hours post operatively. Patients satisfaction with pain management will be evaluated using a five- point verbal satisfaction scale (Likert scale) at the end of first 24 postoperative hours. Hemodynamic parameters and side effects like respiratory depression and pruritis will be recorded.