Comparison of Transverse Thoracic Muscle Plane Block and Erector Spinae Plane Block for post operative analgesic requirement in Adult Cardiac Surgery: A Randomized Controlled Non-Inferiority trial.

This is a prospective randomised non inferiority trail. It compares the post operative analgesia provided by TTMPB and ESPB in patients of 18 to 65 years of age who undergo midline sternotomy for procedures like CABG with only venous graft, MVR, AVR, DVR, VSD and ASD. Patients are screened for inclusion in the study during the pre op evaluation and if they meet the criteria of inclusion and exclusion they are explained about the study and its risk- benefits, written informed consent is taken and also the patient is educated about the NRS pain score. in the OT a skilled anesthetist would provide either of the block depending on the computer generated  sequence after induction of the case. during operation  fentanyl infusion is maintained and extra bolus dose s are given if required. intraoperative vitals and requirement of fentanyl is noted. Post op patients is transfered to ctvs ICU and  hemodynamics guided boluses of fentanyl and  provided and note is made. Patient is extubated once they meet the criteria to extubate and time to extubation noted. Post extubation  NRS scores noted at predefined intervals and in case of complaints of pain. NRS guided fentanyl bolus doses are given and total quantity of fentanyl requirements post op is also noted for post op 24 hrs.

A total of 66 cases are considered to be taken up for the study and conclusion regarding the non inferiority of TTMPB to ESPB will be drawn based on statistical calculation from the data collected.