Effect of Transversus Thoracic Muscle Plane Block (TTMP) on Analgesia

Phase 4

Completed

• Conditions: Coronary Artery Bypass; Anesthesia, Conduction; Nerve Block; Pain, Postoperative
• Interventions: Procedure: Transversus Thoracic Muscle Plane Block; Drug: Tramadol

• Registration Number: NCT06601530
• Lead Sponsor: Istanbul University - Cerrahpasa (IUC)

Brief Summary

In this prospective and controlled study, the investigators investigated the effect of transversus thoracic muscle plane block (TTMP) on analgesia in patients who undergo coronary artery bypass graft (CABG) surgery with median sternotomy. For this purpose, the investigators aimed to compare the hemodynamic responses to surgical incision and sternotomy and, pain intensity, total analgesic consumption, additional analgesic requirements of the patients in the first 24 hours after extubation under postoperative patient-controlled analgesia (PCA) adminisration.

Detailed Description

Forty-six patients aged 18-70 years, ASA class I-III, who undergo CABG surgery were included in our study. The patients were randomized into the TTKPB group and the control group. Heart rate (HR) and mean arterial pressure (MAP) were recorded before peroperative induction, before skin incision, after skin incision, before sternotomy and after sternotomy. PCA with tramadol was applied after extubation and "Numeric rating scale" NRS scores, total tramadol consumption, number of requests and additional analgesic requirements were recorded at 0, 1, 2, 4, 8, 12 and 24 hours.

Study Timeline

• Study Start: 2022-08-01
• Primary Completion: 2022-09-01
• Study Completion: 2022-10-01
• Status Verified: 2024-09
• Study First Submitted: 2024-09-14
• Study First Submitted QC: 2024-09-14
• Last Update Submitted: 2024-09-14
• Study First Posted: 2024-09-19
• Last Update Posted: 2024-09-19

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 46

Inclusion Criteria

• ASA (American Society of Anesthesiologists) classification I-III
• Coronary artery bypass graft operation with median sternotomy under elective conditions

Exclusion Criteria

• Refusing to participate in the study
• Under 18 and over 70
• ASA class IV and above
• EF (Ejection Fraction) < 40%
• Emergency surgery or reoperation
• Intraaortic balloon pump placement
• Known allergy to local anesthetics
• Coagulation disorder
• Infection at the block site
• History of sternotomy
• Those with chronic pain complaints and long-term use of analgesics
• Patients who could not be extubated within 12 hours after the operation

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Transversus Thoracic Muscle Plane Block Group	Transversus Thoracic Muscle Plane Block	Transversus thoracic muscle plane block is a single-shot nerve block technique that provides analgesia for the anterior chest wall
Transversus Thoracic Muscle Plane Block Group	Tramadol	Transversus thoracic muscle plane block is a single-shot nerve block technique that provides analgesia for the anterior chest wall
Control Group	Tramadol	-

Primary Outcome Measures

Name	Time	Method
Numeric Rating Scale (NRS) at rest	Postoperative 24 hours	Numeric Rating Scale (NRS) for postoperative pain
Numeric Rating Scale (NRS) during coughing	Postoperative 24 hours	Numeric Rating Scale (NRS) for postoperative pain
Mean arterial pressure	Peroperative	Peroperative induction, before skin incision, after skin incision, before sternotomy and after sternotomy.
Heart rate	Peroperative	Peroperative induction, before skin incision, after skin incision, before sternotomy and after sternotomy.
Bispectral Index (BIS)	Peroperative	Peroperative induction, before skin incision, after skin incision, before sternotomy and after sternotomy.

Trial Locations

Locations (1)

Istanbul University-Cerrahpasa; 🇹🇷 Istanbul, Fatih, Turkey