bilateral serratus intercostal plane block for myocardial revascularization (serrint)

Conditions: Pain, Postoperative; Pain Management; Analgesia, Patient-Controlled; Nerve Block

Summary: two-parallel arm, double-blind, individually randomized controlled trial. primary endpoint: fentanyl consumption in the first 48 postoperative hours. secondary endpoints: pain at rest, pain on movement, stay in icu, postoperative nausea and vomiting (ponv), sedation, hemothorax, seizures, arrythmias

trial design: two-parallel arm, double-blind, individually randomized controlled trial. primary endpoint: fentanyl consumption in the first 48 postoperative hours. secondary endpoints: pain at rest, pain on movement, stay in icu, postoperative nausea and vomiting (ponv), sedation, hemothorax, seizures, arrythmias inclusion criteria: * patient between 18 years to 80 years. * patient to myocardial revascularization by sternotomy exclusion criteria: * patitient for combined surgery ( myocardial revascularization by sternotomy plus valve or maze) * emergency surgery * ejecction fraction less than 35% * allergy to the local anesthesic. * allergy to opioids * patient in who will be technically impossible the application of the blockade trial treatment: intervention: these patients will receive the protocol multimodal analgesia patients receive on the colombian cardiovascular foundation with lidocaine 0.5mcg/k. dexamethasone 8mcg, fentanyl bolus: 7mcg/k . infusion of fentanyl 4 mcg/k/h start after induction , go down to 2 mcg/k/h during extracorporeal circulation , after extracorporeal circulation the infusion will be suspended of fentanyl.in this arm the patient will give a bilateral serratus intercostal plane block, will be performed echo-guided puncture in the line anterior axillar with fifth costal arch, whit 21 ml of anesthetic mass, 20 ml of levobupivacaine 0.375 and 1 ml (2mg) of dexamethasone. and the postoperative analgesia will be 500mg of acetaminophen oral and analgesia, patient controlled with fentanyl 20mcg/bolus control: these patients will receive the protocol multimodal analgesia patients receive on the colombian cardiovascular foundation with lidocaine 0.5mcg/k. dexamethasone 8mcg, fentanyl bolus: 7mcg/k . infusion of fentanyl 4 mcg/k/h start after induction , go down to 2 mcg/k/h during extracorporeal circulation , after extracorporeal circulation the infusion will be suspended of fentanyl.. and the postoperative analgesia will be 500mg of acetaminophen oral and analgesia, patient controlled with fentanyl 20mcg/bolus expected sample size, enrollment and expected number of centers: sample size = 44 recruitment start date: 15 january of 2019 recruitment end date: 15 july of 2019 follow-up end date: number of centers: 1 statistical considerations: * intention to treat analysis * the primary outcomes will be analyzed using

Eligibility criteria:
inclusion criteria: * patient between 18 years to 80 years * patient to myocardial revascularization by sternotomy exclusion criteria: * patient for combined surgery ( myocardial revascularization by sternotomy plus valve or maze) * emergency surgery * ejection fraction less than 35% * allergy to the local anesthesics. * allergy to opioids * patient in who will be technically impossible the application of the blockade

Keywords: analgesia, patient- controlled, block , pain postoperative