Clinical trial NCT06413290: Doppler Evaluation of Ultrasound-guided Pectointercostal Fascial Plane Block in Cardiac Surgery
Official title: Doppler Evaluation of Ultrasound-guided Pectointercostal Fascial Plane Block in Cardiac Surgery
Study type: OBSERVATIONAL
Overall status: RECRUITING
Conditions: Cardiovascular Surgery
Keywords: regional anesthesia
postoperative pain
doppler ultrasound
cardiovascular surgery
Lead sponsor: Antalya Training and Research Hospital
Sponsor class: OTHER_GOV
First posted: 2024-05-14
Enrollment: 40
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Observational model: CASE_ONLY
Time perspective: PROSPECTIVE
Sampling method: NON_PROBABILITY_SAMPLE
Study population: It is planned to include ASA I-III adult patients who are planned to undergo elective cardiac surgery

Brief summary: The aim of this study was to evaluate the effect of pectointercostal fascial plane block on regional haemodynamic parameters in patients undergoing cardiac surgery.

Detailed description: Perioperative pain management has become an important component of Enhanced Recovery After Surgery (ERAS) protocols in patients undergoing cardiac surgery. Pain is most intense in the first two days after cardiac surgery. Inadequate pain control has been shown to cause an increase in pulmonary complications due to inadequate mobility and coughing, an increase in sympathetic activation, an increase in myocardial infarction and thromboembolic events, delayed wound healing, and prolonged hospital and intensive care unit stay. Non-steroidal anti-inflammatory drugs (NSAIDs), paracetamol, opioids, epidural anesthesia and ultrasound-guided fascial plane blocks are widely used for pain management after cardiac surgery. The pectointercostal fascial plane (PIFP) block is an ultrasound-guided, superficial fascial plane block that can be applied as part of multimodal postoperative analgesia, especially after cardiac surgery. PIFB block has been shown to reduce postoperative analgesic consumption and improve pain scores not only in patients undergoing cardiac surgery but also in non-cardiac surgeries and thoracic procedures. The aim of this study was to evaluate the effect of PIFP block on regional haemodynamic parameters in patients undergoing cardiac surgery.

Eligibility criteria: Inclusion Criteria:

* elective cardiac surgery
* over 18 years, adult
* American Society of Anaesthesiology (ASA) I-III

Exclusion Criteria:

* history of cerebrovascular disease
* history of Alzheimer's disease
* mental disorder
* emergency surgery
* re-operated due to surgery-related complications
* allergy to local anaesthetics
* declining to give written informed consent

Primary outcomes:
measure: blood volume
timeFrame: 1 hour
Secondary outcomes:
measure: postoperative opioid consumption
timeFrame: 24 hours
measure: postoperative Numerical Rating Scale (NRS) pain scores
timeFrame: 24 hours
measure: length of hospital stay
timeFrame: 5 days
Other outcomes:
Locations:
city: Antalya
country: Turkey
facility: University of Health Sciences, Antalya Training and Research Hospital
state: Muratpaşa
Study officials:
affiliation: University of Health Sciences, Antalya Training and Researh Hospital
name: Arzu O Karaveli, M.D.
role: STUDY_DIRECTOR
References:
citation: Khera T, Murugappan KR, Leibowitz A, Bareli N, Shankar P, Gilleland S, Wilson K, Oren-Grinberg A, Novack V, Venkatachalam S, Rangasamy V, Subramaniam B. Ultrasound-Guided Pecto-Intercostal Fascial Block for Postoperative Pain Management in Cardiac Surgery: A Prospective, Randomized, Placebo-Controlled Trial. J Cardiothorac Vasc Anesth. 2021 Mar;35(3):896-903. doi: 10.1053/j.jvca.2020.07.058. Epub 2020 Jul 24.
citation: Ata F, Yilmaz C. Retrospective Evaluation of Fascial Plane Blocks in Cardiac Surgery With Median Sternotomy in a Tertiary Hospital. Cureus. 2023 Mar 3;15(3):e35718. doi: 10.7759/cureus.35718. eCollection 2023 Mar.