Effect of Bilateral Transversus Thoracis Muscle Plane Block in Patients Undergoing Coronary Artery Bypass Graft Surgery.

NCT ID: NCT04849117

Last Updated: 2021-04-19

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

Total Enrollment

100 participants

Study Classification

OBSERVATIONAL

Study Start Date

2018-01-01

Study Completion Date

2019-12-20

Brief Summary

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Coronary artery bypass graft surgery is the standard surgical treatment for coronary disease. However, there is no consensus on analgesic management in patients undergoing CABG.

The aim of the study is to evualuate efficacy of bilateral transversus thoracis muscle plane (TTMP) block combined with systemic analgesia, compared to systemic analgesia only, in patients undergoing elective on-pump CABG surgery.

Our main hypothesis is that a bilateral TTMP block performed after CABG surgery could reduce morphine consumption during the first 48 hours.

The investigators conducted an age, gender and type of surgery-matched retrospective cohort study in the Montpellier University Hospital (France).

Detailed Description

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Conditions

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Coronary Artery Disease Pain Syndrome

Study Design

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Observational Model Type

COHORT

Study Time Perspective

RETROSPECTIVE

Study Groups

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Systemic analgesia

Patients received only systemic analgesia : Acetaminophen, Ketoprofen, and Nefopam were administered systematically. Morphine was administered if necessary, according to our institutional pain management protocol.

No interventions assigned to this group

Bilateral TTMP block + systemic analgesia

Patients received the same protocol of systemic analgesia associated with a bilateral TTMP block performed during the first four hours after ICU admission, before tracheal tube removal.

Ultrasound guided Bilateral Transversus Thoracis Muscle Plane block

Intervention Type PROCEDURE

In the "TTMP block" group, an ultrasounded guided TTMP block was performed by an anesthesiologist, in ICU, before tracheal tube removal. Between the 4th et 5th rib, on each side, 40 ml of Ropivacaine 2 mg/ml, in association with Clonidine, was injected "single-shot" in the tranversus thoracis muscle plane. The targets of local anesthetic were the anterior branches of intercostal nerves from T2 to T6. Dexamethasone 8 mg was injected intravenously.

Interventions

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Ultrasound guided Bilateral Transversus Thoracis Muscle Plane block

In the "TTMP block" group, an ultrasounded guided TTMP block was performed by an anesthesiologist, in ICU, before tracheal tube removal. Between the 4th et 5th rib, on each side, 40 ml of Ropivacaine 2 mg/ml, in association with Clonidine, was injected "single-shot" in the tranversus thoracis muscle plane. The targets of local anesthetic were the anterior branches of intercostal nerves from T2 to T6. Dexamethasone 8 mg was injected intravenously.

Intervention Type PROCEDURE

Other Intervention Names

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Transversus Thoracis Muscle Plane Block. Parasternal Block.

Eligibility Criteria

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Inclusion Criteria

* To be over 18
* To be scheduled for CABG surgery in the center of the study during the study period.

Exclusion Criteria

* Chronic pain or opioid use before surgery
* Recent thoracic regional analgesia (\< 1 month)
* Preoperative dementia or other neurologic or psychiatric disease incompatible with VAS pain scoring.
* Other technique of regional anesthesia (e.g. thoracic epidural)
* Opposition to data collection

Secondary exlusion criteria:

* Postoperative prolonged sedation in ICU (\> 12 hours)
* Postoperative surgical complication requiring surgical revision during the first two days.
* Opposition to data collection expressed secondarily
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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University Hospital, Montpellier

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Pierre Sentenac, MD, PhD

Role: PRINCIPAL_INVESTIGATOR

UH MONTPELLIER

Locations

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Uh Montpellier

Montpellier, , France

Site Status

Countries

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France

Other Identifiers

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RECHMPL19_0582

Identifier Type: -

Identifier Source: org_study_id

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