CompletedNot Applicable

Effects of Serratus Posterior Superior Intercostal Plane Block and Pectoralis Nerve Block in Coronary Artery Surgery

Turkey (Türkiye)68 participantsStarted 2024-02-07

Plain-language summary

Postoperative analgesia is a critical risk factor for the development of pulmonary and cardiovascular complications in all types of chest surgery, particularly coronary artery bypass graft (CABG) surgery. Patients with high levels of pain who cannot breathe effectively may experience atelectasis, cardiac ischemia, and arrhythmias. This prolongs hospitalization and increases the frequency of postoperative pulmonary complications and morbidity. If postoperative acute pain is not adequately treated, it may lead to the development of chronic pain, hindering patients from recovering normal activities for an extended period. In addition to medications, various neuroaxial and peripheral nerve blocks can be used in cardiac surgery. The use of high-dose heparin during surgery, along with neuroaxial anesthesia (thoracic epidural and intrathecal opioids), is controversial. Thoracic paravertebral block (TPVB) has demonstrated efficacy and is considered a method with fewer potential side effects compared to thoracic epidural anesthesia. However, TPVB has become less preferred in cardiac surgery due to its sympathetic blockade. Recently, peripheral nerve blocks have gained popularity as alternatives. These blocks include pectoralis nerve blocks (PECS-I, PECS-II), serratus anterior plane block (SAPB), serratus posterior superior intercostal plane block (SPSIPB), erector spinae plane block (ESPB), transverse thoracic plane blocks (TTMP), pectointercostal-fascial blocks (PIF), and intercostal nerve blocks. These blocks are newer and more superficially located compared to TPVB. Additionally, these fascial blocks are considered safer in terms of side effects as they do not cause sympathetic blockade like TPVB. The hypothesis of this study is that SPSIPB can provide more extensive dermatomal analgesia compared to PECS-II, resulting in more effective postoperative analgesia. Therefore, this study plans to compare the analgesic effects of ultrasound-guided SPSIPB and PECS-II block applications in patients undergoing coronary artery bypass surgery with sternotomy.

Who can participate

Age range18 Years – 65 Years

SexALL

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AI-rewrites the medical criteria so a patient or caregiver can understand them. Always confirm with the trial site.

Inclusion Criteria: * Will undergo CABG surgery * The American Society of Anesthesiologists (ASA) physical classification is 1-2-3. * The volunteer has read and accepted the consent form * Body mass index (BMI) \<35 Exclusion Criteria: * The patient does not want to participate in the study * Patients with BMI \>35 * Patients with ASA 4-5 * Those who are allergic to the local anesthetic used and the specified analgesic drug * Those who declare that they are during pregnancy and breastfeeding * Having uncontrollable anxiety * Those with neuromuscular disease and peripheral nerve diseaseThose who used high doses of opioid medication 3 days before surgery * Widespread chronic pain, diabetes mellitus, hepatic and renal failure * Infection at the peripheral block needle insertion site

What they're measuring

Postoperative Pain Examination with Visual analog scale

Timeframe: 24 hours

Trial details

NCT IDNCT06242431

SponsorHitit University

Sponsor typeOTHER

Study typeINTERVENTIONAL

Primary completion2024-07-15