Comparing Different Regional Blocks for Analgesia After Off-pump Cardiac Surgery

Study Overview
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Brief Summary
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This study aims to compare the analgesic effects of erector spinae plane block versus Superficial Parasternal Intercostal Plane Block block along with rectus sheath block after off-pump cardiac surgery

Detailed Description
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General anaesthesia will be used for all patients. induction by midazolam 0.05-0.1 mg/kg, fentanyl 2-5 µ/kg, propofol 1-2 mg/kg, and atracurium 0.5 mg/kg for intubation. Maintenance by sevoflurane in oxygen-air mixture. regional blocks will be used after the induction of anaesthesia. Intraoperative analgesia will be maintained by fentanyl infusion 1-2 µ/kg/h while morphine sulphate 2.5-5mg will be used as rescue analgesia when pain score>4 beside acetaminophen 1000 mg /6 hours

Official Title
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Analgesic Effects of Erector Spinae Plane Block Versus Superficial Parasternal Intercostal Plane Block Combined With Rectus Sheath Block After Off Pump Cardiac Surgery: A Randomised Trial

Conditions
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Analgesia

Intervention / Treatment
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* Other: Erector Spinae Plane Block
* Other: Superficial Parasternal Intercostal Plane Block combined with Rectus Sheath Block


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: American Society of anaesthesiologists physical status classification II-III Elective off-pump cardiac surgery Exclusion Criteria: Cognitive impairment Allergy to local anaesthetics Renal and/or hepatic dysfunction Ejection fraction< 45%

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 80 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Other: Erector Spinae Plane Block group<br>Erector Spinae Plane Block | Other: Erector Spinae Plane Block<br>* Erector Spinae Plane Block<br>|
| Other: Superficial Parasternal Intercostal Plane Block and Rectus Sheath Block group<br>Superficial Parasternal Intercostal Plane Block and Rectus Sheath Block | Other: Superficial Parasternal Intercostal Plane Block combined with Rectus Sheath Block<br>* Superficial Parasternal Intercostal Plane Block combined with Rectus Sheath Block<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Total opioid consumption | µg and mg | Perioperative. | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Pain intensity at rest and exercise | Visual analogue score: a score from 0 to 10(0= no pain and 10 the worst imaginable pain) | Perioperative. | 
| Extubation time | minutes | Perioperative | 
| Duration of post anaesthesia care unit stay | minutes | Perioperative | 
| Postoperative nausea | number (%) | Perioperative | 
| Postoperative vomiting | number (%) | Perioperative | 
| Duration of hospital stay | days | Postoperative up to 4 weeks |