Clinical trial NCT06516432: Parasternal Blockade and Serum Lactate in Cardiac Surgery
Official title: Serum Lactate in the Application of Parasternal Blockade in Trans and Post Anesthetic Stages in Cardiac Surgery
Study type: INTERVENTIONAL
Overall status: RECRUITING
Phase: NA
Conditions: Elective Cardiac Surgery
Keywords: Parasternal block
Cardiac surgery
Serum lactate
Lead sponsor: Instituto Mexicano del Seguro Social
Sponsor class: OTHER_GOV
First posted: 2024-07-24
Enrollment: 86
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: NON_RANDOMIZED
Intervention model: PARALLEL
Intervention model description: Patients will be classified into a case group with parasternal block and a control group without parasternal block, with a ratio of cases to controls of 1:1.

In the case-control groups, patients with elevated serum lactate levels above 2 mmol/L and those who remained below this limit will be identified.
Primary purpose: SUPPORTIVE_CARE

Brief summary: Serum lactate level is a key indicator of tissue perfusion. Parasternal blockade is associated with reduced postoperative inflammatory response by inhibiting stress response, leading to better outcomes. Elevated lactate levels help identify patients at risk of postoperative morbidity and mortality. This analytical cross-sectional study evaluated the association between parasternal blockade and serum lactate levels in patients undergoing elective cardiac surgery in 2022 at Specialty Hospital CMNO. Patients with and without parasternal block were compared for changes in serum lactate levels during and after anesthesia within the first 24 hours.

Detailed description: Background: Serum lactate level is a crucial indicator of tissue perfusion. Parasternal blockade has been related to a reduction of the postoperative inflammatory response, by inhibition of the stress response, leading to a better prognosis. Increased lactate level is a useful parameter in the identification of patients at risk of postoperative morbidity and mortality.

Objective: To evaluate the association between parasternal blockade and serum lactate level in patients undergoing cardiac surgery, both trans and postanesthesia.

Materials and Methods: Analytical cross-sectional study in adult patients undergoing elective cardiac surgery during the year 2022 in Specialty Hospital CMNO, patients with and without application of parasternal block were analyzed, and it was associated with changes in serum lactate level trans and post anesthesia in the first 24 hours. Approval registration: R-2023-1301-024.

Eligibility criteria: Inclusion Criteria:

* Adult patients older than 18 years
* Either sex
* ASA II-III
* Patients who underwent cardiac surgery with median sternotomy and use of cardiopulmonary bypass.

Exclusion Criteria:

* Patients with pre-existing conditions that could independently affect serum lactate levels.

Primary outcomes:
measure: Serum lactate measurement
timeFrame: 24 hours postoperative
Secondary outcomes:
Other outcomes:
Locations:
city: Guadalajara
country: Mexico
facility: Centro Médico Nacional de Occidente
state: Jalisco
Study officials:
affiliation: IMSS
name: Alejandro Gonzalez, 3
role: PRINCIPAL_INVESTIGATOR
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