Impact of Bilateral Deep Parasternal Intercostal Plane Block on Intraoperative Opioid Consumption in Open Heart Surgery

NCT ID: NCT05103787

Last Updated: 2021-11-02

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

UNKNOWN

Clinical Phase

NA

Total Enrollment

30 participants

Study Classification

INTERVENTIONAL

Study Start Date

2021-10-04

Study Completion Date

2022-07-04

Brief Summary

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This study aims to assess the impact of bilateral deep parasternal intercostal plane block on intraoperative opioid consumption in open heart surgery

Detailed Description

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High-dose opioid is associated with various side effects such as nausea, vomiting, urinary retention, and respiratory depression. The neuraxial block (intrathecal, epidural) and peripheral nerve block are regional anesthesia techniques which have the potential to reduce intraoperative opioid consumption. The deep parasternal intercostal plane block is fascial plane block which intended to block anterior cutaneous branch of intercostal nerves.

This study is a double-blind randomized controlled trial. Thirty subjects will be recruited with consecutive sampling method. Eligible subjects with signed informed consent will be randomized into two groups. The first group is the treatment group who will receive bilateral deep parasternal intercostal plane block after induction of anesthesia and the second group will be the control group who will not receive any regional anesthesia. After surgery, extubation time, adverse event (nausea, vomiting), and intensive care unit length of stay will be recorded for both groups.

Conditions

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Opioid Use

Keywords

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regional anesthesia intercostal plane block opioid open heart surgery

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Investigators

Study Groups

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deep parasternal plane block

Subjects will receive bilateral deep parasternal intercostal plane block after induction of anesthesia.

Group Type ACTIVE_COMPARATOR

deep parasternal intercostal plane block

Intervention Type PROCEDURE

Twenty milliliters of 0.25% bupivacaine will be placed bilaterally in the fascial plane between internal intercostal muscle and transversus thoracis muscle at intercostal space 4 or 5, lateral from sternum, with ultrasound guidance using high-frequency linear transducer.

control

Intervention Type PROCEDURE

Skin puncture with needle will be performed on the same location as the treatment group without administration of local anesthetics.

control

subjects will receive skin puncture with needle on the same location as the treatment group without administration of local anesthetics after induction of anesthesia,

Group Type PLACEBO_COMPARATOR

deep parasternal intercostal plane block

Intervention Type PROCEDURE

Twenty milliliters of 0.25% bupivacaine will be placed bilaterally in the fascial plane between internal intercostal muscle and transversus thoracis muscle at intercostal space 4 or 5, lateral from sternum, with ultrasound guidance using high-frequency linear transducer.

control

Intervention Type PROCEDURE

Skin puncture with needle will be performed on the same location as the treatment group without administration of local anesthetics.

Interventions

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deep parasternal intercostal plane block

Twenty milliliters of 0.25% bupivacaine will be placed bilaterally in the fascial plane between internal intercostal muscle and transversus thoracis muscle at intercostal space 4 or 5, lateral from sternum, with ultrasound guidance using high-frequency linear transducer.

Intervention Type PROCEDURE

control

Skin puncture with needle will be performed on the same location as the treatment group without administration of local anesthetics.

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* Age 18-70 years old
* Elective open-heart surgery with median sternotomy approach

Exclusion Criteria

* Patient who refuses to participate
* Patient with local infection in the block area
* Patient with chronic pain
* Patient with history of chronic analgesics use
* Patient who is contraindicated for local anesthetics
* Patient with cognitive disorder
* Patient with severe psychiatric disorders
Minimum Eligible Age

18 Years

Maximum Eligible Age

70 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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Indonesia University

OTHER

Sponsor Role lead

Responsible Party

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Aida Rosita Tantri

Doctor

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Aida Rosita R Tantri

Role: PRINCIPAL_INVESTIGATOR

Indonesia University

Locations

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Cipto Mangunkusumo Cental National Hospital

Jakarta, DKI Jakarta, Indonesia

Site Status RECRUITING

Universitas Indonesia

Central Jakarta, Indonesia, Indonesia

Site Status RECRUITING

Countries

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Indonesia

Central Contacts

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Aida Rosita R Tantri, doctor

Role: CONTACT

Phone: 0213143336

Email: [email protected]

A A G Putra Semara, doctor

Role: CONTACT

Phone: 0213143336

Facility Contacts

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Aida R Tantri, Consultant

Role: primary

Aida Rosita R Tantri

Role: primary

References

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Aydin ME, Ahiskalioglu A, Ates I, Tor IH, Borulu F, Erguney OD, Celik M, Dogan N. Efficacy of Ultrasound-Guided Transversus Thoracic Muscle Plane Block on Postoperative Opioid Consumption After Cardiac Surgery: A Prospective, Randomized, Double-Blind Study. J Cardiothorac Vasc Anesth. 2020 Nov;34(11):2996-3003. doi: 10.1053/j.jvca.2020.06.044. Epub 2020 Jun 18.

Reference Type RESULT
PMID: 32665179 (View on PubMed)

Cardinale JP, Latimer R, Curtis C, Bukovskaya Y, Kosarek L, Falterman J, Tatum DM, Trusheim J. Incorporation of the Transverse Thoracic Plane Block Into a Multimodal Early Extubation Protocol for Cardiac Surgical Patients. Semin Cardiothorac Vasc Anesth. 2021 Dec;25(4):301-309. doi: 10.1177/1089253220957484. Epub 2020 Sep 9.

Reference Type RESULT
PMID: 32907499 (View on PubMed)

Chin KJ. An Anatomical Basis for Naming Plane Blocks of the Anteromedial Chest Wall. Reg Anesth Pain Med. 2017 May/Jun;42(3):414-415. doi: 10.1097/AAP.0000000000000575. No abstract available.

Reference Type RESULT
PMID: 28419049 (View on PubMed)

Bloc S, Perot BP, Gibert H, Law Koune JD, Burg Y, Leclerc D, Vuitton AS, De La Jonquiere C, Luka M, Waldmann T, Vistarini N, Aubert S, Menager MM, Merzoug M, Naudin C, Squara P. Efficacy of parasternal block to decrease intraoperative opioid use in coronary artery bypass surgery via sternotomy: a randomized controlled trial. Reg Anesth Pain Med. 2021 Aug;46(8):671-678. doi: 10.1136/rapm-2020-102207. Epub 2021 May 14.

Reference Type RESULT
PMID: 33990437 (View on PubMed)

Vilvanathan S, Saravanababu MS, Sreedhar R, Gadhinglajkar SV, Dash PK, Sukesan S. Ultrasound-guided Modified Parasternal Intercostal Nerve Block: Role of Preemptive Analgesic Adjunct for Mitigating Poststernotomy Pain. Anesth Essays Res. 2020 Apr-Jun;14(2):300-304. doi: 10.4103/aer.AER_32_20. Epub 2020 Oct 12.

Reference Type RESULT
PMID: 33487833 (View on PubMed)

Probst S, Cech C, Haentschel D, Scholz M, Ender J. A specialized post anaesthetic care unit improves fast-track management in cardiac surgery: a prospective randomized trial. Crit Care. 2014 Aug 15;18(4):468. doi: 10.1186/s13054-014-0468-2.

Reference Type RESULT
PMID: 25123092 (View on PubMed)

Wong WT, Lai VK, Chee YE, Lee A. Fast-track cardiac care for adult cardiac surgical patients. Cochrane Database Syst Rev. 2016 Sep 12;9(9):CD003587. doi: 10.1002/14651858.CD003587.pub3.

Reference Type RESULT
PMID: 27616189 (View on PubMed)

Chakravarthy M. Regional analgesia in cardiothoracic surgery: A changing paradigm toward opioid-free anesthesia? Ann Card Anaesth. 2018 Jul-Sep;21(3):225-227. doi: 10.4103/aca.ACA_56_18. No abstract available.

Reference Type RESULT
PMID: 30052206 (View on PubMed)

Other Identifiers

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IndonesiaUAnes119

Identifier Type: -

Identifier Source: org_study_id