Combine Serratus Anterior Plane Block Versus Erector Spinae Plane Block in Coronary Bypass Surgery

Not Applicable

Completed

• Conditions: Cardiac Surgery; Postoperative Pain; Regional Anesthesia Morbidity
• Interventions: Procedure: ESP block; Procedure: CASP block

• Registration Number: NCT05308797
• Lead Sponsor: Ankara City Hospital Bilkent

Brief Summary

Even though Erector Spinae Plane (ESP) Block is shown to be efficient in cardiac surgery, the Combine Serratus Anterior Plane (CSAP) Block is still controversial if it has an efficient analgesic effect for sternotomy and drain tube pain relief. This study aims to compare ESP block and CSAP block for postoperative analgesia in coronary bypass surgery patients.

Detailed Description

Acute postoperative pain after cardiac surgery originates various surgical procedures that may cause pain including the incision of tissues, sternotomy, the separation of bone-joint structures, the severity and duration of these applications, the use of chest tubes, and the patient's personal inflammatory may affect the response to these stimuli. Postoperative pain is a critical risk factor for the development of pulmonary and cardiovascular complications such as atelectasis, cardiac ischemia, and arrhythmias. Researchers claim that adding techniques to iv drugs, such as thoracic epidural anesthesia, paravertebral block, or erector spinae plane block (ESP) to multimodal analgesia regimens positively affect recovery. Although the efficacy of ESP block in providing postoperative analgesia has been demonstrated in many studies, there is no study comparing CSAP and ESP block in cardiac surgery.

Study Timeline

• Study First Submitted: 2022-03-18
• Study First Submitted QC: 2022-04-01
• Study First Posted: 2022-04-04
• Study Start: 2022-05-01
• Primary Completion: 2022-11-01
• Study Completion: 2022-12-01
• Status Verified: 2023-01
• Last Update Submitted: 2023-01-18
• Last Update Posted: 2023-01-19

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 60

Inclusion Criteria

• Adult patients who will undergo coronary artery bypass grafting surgery with median sternotomy

Exclusion Criteria

• Emergency surgeries
• Patients with allergic reactions to anesthesia and analgesia drugs to be used
• Patients who do not want to participate in the study voluntarily
• Severe systemic disease (kidney, liver, pulmonary, endocrine)
• Substance abuse history
• History of chronic pain
• Psychiatric problems and communication difficulties
• Patients who need revision due to hemostasis in the postoperative period
• Patients with severe hemodynamic instability due to infection, heavy bleeding, etc.

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Erector Spinae Plane Block	ESP block	An erector spinae plane block will be performed at the level of the 5th thoracic vertebrae with 30 mL of 0.25% bupivacaine solution under ultrasound guidance before the operation.
Combine Serratus Anterior Plane Block	CASP block	Combine Serratus Anterior Plane block will be performed at the level of 5th costa with 30 mL of 0.25% bupivacaine (15 mL superficial serratus plane block and 15 mL deep serratus plane block) solution under ultrasound guidance before the operation.

Primary Outcome Measures

Name	Time	Method
Postoperative 6 hour measurement	6 hour after ICU admission, an average of 5 minutes	patients will be evaluated in terms of the visual analog pain scale, the scale has a range of 0 to 10. The scale will be shown to patients and 0 means the patient has no pain, 10 means the patient feels the most pain ever felt.
Postoperative 2 hour measurement	2 hour after ICU admission, an average of 5 minutes	patients will be evaluated in terms of the visual analog pain scale, the scale has a range of 0 to 10. The scale will be shown to patients and 0 means the patient has no pain, 10 means the patient feels the most pain ever felt.
Postoperative 4 hour measurement	4 hour after ICU admission, an average of 5 minutes	patients will be evaluated in terms of the visual analog pain scale, the scale has a range of 0 to 10. The scale will be shown to patients and 0 means the patient has no pain, 10 means the patient feels the most pain ever felt.
Postoperative 12 hour measurement	12 hour after ICU admission, an average of 5 minutes	patients will be evaluated in terms of the visual analog pain scale, the scale has a range of 0 to 10. The scale will be shown to patients and 0 means the patient has no pain, 10 means the patient feels the most pain ever felt.
Postoperative 24 hour measurement	24 hour after ICU admission, an average of 5 minutes	patients will be evaluated in terms of the visual analog pain scale, the scale has a range of 0 to 10. The scale will be shown to patients and 0 means the patient has no pain, 10 means the patient feels the most pain ever felt.

Secondary Outcome Measures

Name	Time	Method
Intensive care unit duration	postoperative, approximately 12 to 36 hours	The total time until patients suitable for discharge from intensive care unit
Mechanical ventilation duration	postoperative, approximately 4 to 10 hours	he total time until patients suitable for endotracheal extubation

Trial Locations

Locations (1)

Ankara City Hospital; 🇹🇷 Ankara, Turkey