Optimal Timing of Parasternal Intercostal Nerve Block Application for Acute Pain Management in Cardiac Surgery
NCT ID: NCT05363540
Last Updated: 2023-06-22
Study Results
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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COMPLETED
NA
51 participants
INTERVENTIONAL
2022-03-22
2022-12-24
Brief Summary
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many facial plane blocks have been introduced as simple and safe intervention for thoracic wall anesthesia and analgesia. Parasternal intercostal nerve block (PSIB) is a "superficial block" which involves local anesthetic (LA) infiltration in the intercostal space around the sternum where the anterior branches of intercostal nerves exist.
Intraoperative LA administration under direct vision of the surgeon ensures adequate delivery of drugs and minimizes bleeding complication or inadvertent administration in blood vessels. Meanwhile, Preoperative administration of LA guided by ultrasound imaging has been used in variable surgical settings with noticeable success because of preemptive inhibition of noxious stimuli.
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Detailed Description
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Conditions
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Study Design
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RANDOMIZED
PARALLEL
PREVENTION
DOUBLE
Study Groups
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Pre-incisional parasternal block
ultrasound guided parasternal intercostal block will be administrated before surgical incision.
pre-incisional parasternal intercostal block
LA will be administrated by the anesthesiologist under ultrasound guidance and before surgical incision On either side of thorax, 2 cm lateral to sternal edge from 2nd to 6th intercostal space, A volume of (4 mL) of 0.25% bupivacaine will be used
Post-incisional parasternal block
under direct vision parasternal intercostal block will be administrated after surgical incision and before closure of the sternum.
post-incisional parasternal intercostal block
LA will be administered by the cardiac surgeon before the sternal closure. injection will introduced 2 cm lateral to sternal edge from 2nd to 6th intercostal space and volume (4 mL) of 0.25% bupivacaine will be used.
Interventions
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pre-incisional parasternal intercostal block
LA will be administrated by the anesthesiologist under ultrasound guidance and before surgical incision On either side of thorax, 2 cm lateral to sternal edge from 2nd to 6th intercostal space, A volume of (4 mL) of 0.25% bupivacaine will be used
post-incisional parasternal intercostal block
LA will be administered by the cardiac surgeon before the sternal closure. injection will introduced 2 cm lateral to sternal edge from 2nd to 6th intercostal space and volume (4 mL) of 0.25% bupivacaine will be used.
Eligibility Criteria
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Inclusion Criteria
* Scheduled to undergo elective cardiac surgeries through median sternotomy involving cardiopulmonary bypass (CPB).
Exclusion Criteria
* patients who have previous cardiac surgery,
* prolonged CPB time (CPB\>120 minutes),
* Intubation time more than 12hrs or planned for overnight ventilation.
* Allergy to any of used drugs,
* opioids addiction,
* Chronic liver disease, chronic renal disease, and cognitive impairment.
20 Years
70 Years
ALL
No
Sponsors
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Benha University
OTHER
Responsible Party
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Samar Rafik Mohamed Amin
lecturer of anesthesia and surgical ICU
Locations
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Samar Rafik Amin
Banhā, Qalyubia Governorate, Egypt
Countries
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Other Identifiers
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RC.1-3-2022
Identifier Type: -
Identifier Source: org_study_id
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