Transversus Thoracis Muscle Plane Block for Postoperative Pain in Adult Cardiac Surgery

NCT ID: NCT04591119

Last Updated: 2023-12-05

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

75 participants

Study Classification

INTERVENTIONAL

Study Start Date

2020-10-20

Study Completion Date

2020-12-21

Brief Summary

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Inadequate pain control after coronary artery bypass graft surgery increases mortality and results in a higher incidence of persistent poststernotomy pain syndrome. Our aim is to assess whether ultrasound-guided parasternal intercostal block (PSIB) or surgeon implied transversus thoracic muscle plane block (TTMPB) would improve the postoperative pain scores and decrease tramadol consumption better after coronary artery bypass graft surgery

Detailed Description

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Conditions

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Postoperative Pain Chest Pain Coronary Artery Bypass Sternotomy

Keywords

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adult cardiac surgery poststernotomy pain transversus thoracic muscle plane block parasternal intercostal block behavioral pain scale numeric rating scale

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

TRIPLE

Participants Caregivers Outcome Assessors

Study Groups

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Transversus Thoracic Muscle Plane Block (TTMPB) Group

At the TTMPB group, the block will be performed by the surgeon before the closure of the sternum by visualizing the muscles and identifying them. In the TTMPB group patients will receive 40 ml %0.375 bupivacaine divided into 4 equal doses between internal intercostal muscle and transversus thoracic muscle at the 2nd and 3rd intercostal space and 4th and 5th intercostal space.

Group Type ACTIVE_COMPARATOR

Transversus Thoracic Muscle Plane Block

Intervention Type PROCEDURE

40 ml %0.375 bupivacaine divided into 4 equal doses will be injected by the surgeon between internal intercostal muscle and transversus thoracis muscle at the 2nd and 3rd intercostal space and 4th and 5th intercostal space

Parasternal Intercostal Block (PSIB) Group

At the PSIB group, the block will be performed by ultrasound guidance after completion of surgery. PSIB Blocks will be performed under ultrasonography guidance using a linear 6 to 13 megahertz ultrasound probe by the anesthesist.In PSIB group patients will receive 40 ml %0.375 bupivacaine divided into 4 equal doses between psoas major muscle and external intercostal muscle at the 2nd and 3rd intercostal space and 4th and 5th intercostal space bilaterally.

Group Type ACTIVE_COMPARATOR

Parasternal Intercostal Plane Block

Intervention Type PROCEDURE

40 ml %0.375 bupivacaine injection will be performed by ultrasound guidance after completion of surgery between pectoralis major muscle and external intercostal muscle at the 2nd and 3rd intercostal space and 4th and 5th intercostal space bilaterally by anesthesiologist.

Control Group

At the control group, no intervention for pain management will be done.

Group Type NO_INTERVENTION

No interventions assigned to this group

Interventions

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Transversus Thoracic Muscle Plane Block

40 ml %0.375 bupivacaine divided into 4 equal doses will be injected by the surgeon between internal intercostal muscle and transversus thoracis muscle at the 2nd and 3rd intercostal space and 4th and 5th intercostal space

Intervention Type PROCEDURE

Parasternal Intercostal Plane Block

40 ml %0.375 bupivacaine injection will be performed by ultrasound guidance after completion of surgery between pectoralis major muscle and external intercostal muscle at the 2nd and 3rd intercostal space and 4th and 5th intercostal space bilaterally by anesthesiologist.

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* American Society of Anesthesiologists physical status II-III
* Elective coronary artery bypass graft surgery under general anesthesia

Exclusion Criteria

* American Society of Anesthesiologists physical status IV
* Emergency surgery and redo surgery
* Low cardiac output syndrome, perioperative intra-aortic balloon pump support for any reason, bleeding disorder or abnormal coagulation profile, abnormal hepatic and renal parameters, uncontrolled diabetes mellitus, chronic obstructive pulmonary disease, atrial fibrillation on anticoagulation
* Allergy to any study drugs, local infection at the block site
* Opioid abuse
Minimum Eligible Age

45 Years

Maximum Eligible Age

80 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Muğla Sıtkı Koçman University

OTHER

Sponsor Role lead

Responsible Party

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Melike Korkmaz Toker

Assistant Professor

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Melike Korkmaz Toker, Assist.Prof

Role: PRINCIPAL_INVESTIGATOR

Mugla Sıtkı Kocman University Department of Anesthesiology and Reanimation

Locations

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Mugla Sıtkı Kocman University Training nad research Hospital

Muğla, , Turkey (Türkiye)

Site Status

Countries

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Turkey (Türkiye)

References

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Ueshima H, Takeda Y, Ishikawa S, Otake H. RETRACTED: Ultrasound-guided transversus thoracic muscle plane block: a cadaveric study of the spread of injectate. J Clin Anesth. 2015 Dec;27(8):696. doi: 10.1016/j.jclinane.2015.05.013. Epub 2015 Jul 3. No abstract available.

Reference Type BACKGROUND
PMID: 26144912 (View on PubMed)

de la Torre PA, Garcia PD, Alvarez SL, Miguel FJ, Perez MF. A novel ultrasound-guided block: a promising alternative for breast analgesia. Aesthet Surg J. 2014 Jan 1;34(1):198-200. doi: 10.1177/1090820X13515902. No abstract available.

Reference Type BACKGROUND
PMID: 24396082 (View on PubMed)

Other Identifiers

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MSKU 20-IV

Identifier Type: -

Identifier Source: org_study_id