Clinical trial NCT06559683: Comparison of Sensory Analysis After Superficial and Deep Parasternal Intercostal Plane Blocks
Official title: Comparison of Maximum Extension of Sensory Assessment Following Superficial and Deep Parasternal Intercostal Plane Blocks
Study type: OBSERVATIONAL
Overall status: COMPLETED
Conditions: Pain, Postoperative
Keywords: analgesia
pain Management
sensory assessment
Lead sponsor: Ondokuz Mayıs University
Sponsor class: OTHER
First posted: 2024-08-19
Enrollment: 33
Sex: ALL
Minimum age (years): 18
Maximum age (years): 85
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Observational model: COHORT
Time perspective: PROSPECTIVE
Sampling method: NON_PROBABILITY_SAMPLE
Study population: Patients scheduled for median sternotomy as part of open-heart surgery and who have received either a superficial or deep parasternal intercostal plane block will be enrolled

Brief summary: Postoperative pain following cardiac surgery is a common issue that can negatively impact patients' quality of life. Effective perioperative pain management is crucial to improving patient outcomes. Pain is typically most intense during the first two postoperative days, and inadequate management can lead to chronic pain, further diminishing quality of life. Recent advances in ultrasound-guided regional anesthesia, including superficial and deep parasternal intercostal plane blocks, have enhanced acute pain control. These blocks aim to provide analgesia by targeting the anterior cutaneous branches of the T2-6 thoracic nerves. While their efficacy is recognized, sensory evaluation and dermatomal analysis remain unexplored. Cadaver studies suggest that the deep block may cover more parasternal space than the superficial block.

Detailed description: This observational study evaluates sensory blocks in patients undergoing open-heart surgery who receive superficial or deep parasternal intercostal plane blocks. Sensory assessment, conducted by a blinded researcher 30 minutes post-block, involves applying small ice tubes with cold sensations categorized as Normal, Reduced, or No cold. A successful block is defined as the loss or reduction of cold sensitivity, while normal cold sensation indicates block failure. Assessments start at the midline, moving laterally to the anterior axillary line. Marked areas are digitally analyzed. Block regression is evaluated at 12 and 24 hours post-procedure using the same cold assessment criteria.

Eligibility criteria: Inclusion Criteria:

* Patients who will undergo effective open heart surgery with median sternotomy
* Patients who have undergone superficial or deep parasternal intercostal plane block

Exclusion Criteria:

* Patients with severe psychiatric illnesses such as psychosis or dementia that would prevent communication with the patient
* Patients who do not want to participate in the study
* Redo surgeries
* Patients whose block is considered unsuccessful with the cold application test at the 30th minute
* Patients who cannot be extubated 12 hours post-block.

Primary outcomes:
measure: Extent of Sensory Blockade Measured by Cold Sensation Testing Across the Anterior Chest Wall Following Deep and Superficial Parasternal Intercostal Plane Blocks.
timeFrame: 30 minutes after the blocks
Secondary outcomes:
measure: Regression of Sensory Blockade at 12 and 24 Hours Post-Block
timeFrame: Postoperative Day 1
measure: Opioid Consumption
timeFrame: Postoperative Day 1
measure: Acute pain scores
timeFrame: Postoperative Day 1
Other outcomes:
Locations:
city: Samsun
country: Turkey
facility: Ondokuz Mayis University
Study officials:
References: