Comparison of Erector Spiane Plan Block (ESPB) Versus Pecto-intercostal Fascial Block(PIFB) for Analgesia and Respiratory Function Recovery in Cardiac Surgery: a Randomized Control Trial
Overview
- Phase
- Not Applicable
- Intervention
- Erector spinae plane block (ESPB)
- Conditions
- Analgesia
- Sponsor
- Taichung Veterans General Hospital
- Enrollment
- 80
- Locations
- 1
- Primary Endpoint
- 48hr opioid consumption
- Status
- Recruiting
- Last Updated
- 2 months ago
Overview
Brief Summary
This clinical trial compares analgesia efficiency and recovery outcomes between two different fascial plane block techniques (ESPB vs.PIFB) in cardiac surgery patients participant population/health conditions].
The main questions it aims to answer are:
- Does ESPB provide superior analgesia than PIFB
- Do patients who receive ESPB have better recovery outcomes
Detailed Description
Regional nerve blocks, including Pecto-intercostal block (PIFB) and Erector spinae plane block (ESPB), can provide a certain level of analgesia for thoracic and cardiac surgeries. This study focuses on patients undergoing their first conventional sternotomy for cardiac surgery. They are randomly assigned to receive either PIFB or ESPB for pain relief. Comparisons are made between the two groups for postoperative 48-hour analgesic medication requirements, static and dynamic postoperative pain scores, improvements in postoperative respiratory function, quality of life index (QoL15), and other clinically relevant prognostic indicators.
Investigators
Yi-Ting Chang
Attending Anesthesiologist
Taichung Veterans General Hospital
Eligibility Criteria
Inclusion Criteria
- •Adults patients, elective and first-time cardiac surgery patients undergoing traditional sternotomy. Procedures include coronary artery bypass surgery, valve repair or replacement surgery, atrial and ventricular septal defect repair surgery, and other open-heart surgeries.
Exclusion Criteria
- •1\. Emergency surgery
- •Anticipated combined major aortic vascular surgery
- •Already admitted to the ICU or on a ventilator before surgery.
Arms & Interventions
Group E
Patients who receive erector spinae plane block(ESPB) before cardiac surgery
Intervention: Erector spinae plane block (ESPB)
Group P
Patients who receive Pecto-intercostal plane block(PIFB) before cardiac surgery
Intervention: Pecto-intercostal fascial plane blok (PIFB)
Outcomes
Primary Outcomes
48hr opioid consumption
Time Frame: Day 2
The primary outcome of this study was the total oral morphine equivalent (OME) dose received within 48 hours after surgery. OME was calculated using a conversion toolkit within our hospital's electronic medical record system, which standardizes opioid analgesic doses to oral morphine equivalents according to established guidelines
Secondary Outcomes
- Postoperative static pain scores-Day 1(Day 1)
- postoperative incentive spirometry volume (ml)-Day 3(Day 3)
- Postoperative dynamic pain scores-Day 1(Day 1)
- Postoperative dynamic pain scores-Day 2(Day 2)
- postoperative incentive spirometry volume (ml)-Day 2(Day 2)
- postoperative incentive spirometry volume (ml)-Day 1(Day 1)
- Postoperative static pain scores-Day 2(Day 2)
- QoL15 (POD3)(Day 3)
- Serum cytokine (IL-6, IL-8, IL-10) - baseline(During surgery (at the time the induction phase was completed, patients were under general anesthesia, and both arterial line and central venous line were in place))
- Serum cytokine (IL-6, IL-8, IL-10)- aortic declamp(Within 10 min after the aortic declamping)
- Serum cytokine (IL-6, IL-8, IL-10)- 6hrs after aortic decalmped(6 hours after the aorta was declamped)
- Serum cytokine (IL-6, IL-8, IL-10)-24 hrs after surgery(24 hours after the surgery)