Study Results
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Basic Information
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UNKNOWN
PHASE3
120 participants
INTERVENTIONAL
2023-02-01
2023-07-01
Brief Summary
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Regional blocks allow better pain control and avoid side effects of opioid based pain control
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Detailed Description
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Introduction:
Pain control is a vital component to achieve enhanced recovery after cardiac surgery. Effective postoperative pain control will reduce the incidence of numerous postoperative complications, can facilitate early mobilization and may result in earlier recovery.
Pain control is historically achieved by the administration of opioids, which is associated with well-documented side effects, such as sedation, respiratory depression, pruritus, hallucinations and postoperative nausea and vomiting (PONV). Enhanced recovery following coronary artery bypass grafting (CABG) has gained attention even though there is limited evidence on the efficacy and effectiveness of existing analgesic techniques.
The external oblique intercostal plane and pectointercostal plane blocks are a new modality that will be used to improve pain-related outcomes after CABG surgery, and has not been extensively investigated. Therefore, we will test the hypothesis that external oblique intercostal plane and pectointercostal plane blocks can reduce cumulative opioid consumption for the patients undergoing CABG surgery when added to conventional multi-model intravenous analgesic technique.
The aim of this prospective comparative investigation is to assess the impact of external oblique intercostal plane and pectointercostal plane blocks in a multimodal perioperative analgesic regimen and any related side effects in patients undergoing CABG surgery.
Patients and Methods:
A prospective study will be carried out in Alexandria Main University Hospital on 120 American society of anaesthesiologists (ASA) II, III physical status aged 40-60 years scheduled for major upper abdominal surgery, after approval of the Medical Ethics Committee and an informed written consent. Patients will be categorized into two equal groups, group I (60) will be subjected to bilateral external oblique intercostal plane and pectointercostal plane blocks and group II (60) will be subjected to fentanyl infusion at a rate of 1μg/kg/h. During the patient stay in the ICU, total analgesic requirements will be measured in both groups. Also, sedation level, duration of intubation and length of ICU stay will be assessed.
Conditions
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Study Design
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RANDOMIZED
PARALLEL
TREATMENT
DOUBLE
Study Groups
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Block group
Patients will be subjected to bilateral external oblique intercostal plane and pectointercostal plane blocks
Pectointercostal plane block and external oblique intercostal plane block
Patients will be subjected to bilateral external oblique intercostal plane and pectointercostal plane blocks
Opioid group
Patients will be subjected to fentanyl infusion at a rate of 1μg/kg/h
Fentanyl infusion
Patients will be subjected to fentanyl infusion at a rate of 1μg/kg/h
Interventions
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Pectointercostal plane block and external oblique intercostal plane block
Patients will be subjected to bilateral external oblique intercostal plane and pectointercostal plane blocks
Fentanyl infusion
Patients will be subjected to fentanyl infusion at a rate of 1μg/kg/h
Eligibility Criteria
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Inclusion Criteria
Exclusion Criteria
* allergy for drugs used
* complicated cases
* patient refusal
* chronic opioid use
* cognitive dysfunction
* chronic kidney disease
ALL
No
Sponsors
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Alexandria University
OTHER
Responsible Party
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Central Contacts
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References
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Engelman DT, Ben Ali W, Williams JB, Perrault LP, Reddy VS, Arora RC, Roselli EE, Khoynezhad A, Gerdisch M, Levy JH, Lobdell K, Fletcher N, Kirsch M, Nelson G, Engelman RM, Gregory AJ, Boyle EM. Guidelines for Perioperative Care in Cardiac Surgery: Enhanced Recovery After Surgery Society Recommendations. JAMA Surg. 2019 Aug 1;154(8):755-766. doi: 10.1001/jamasurg.2019.1153.
Other Identifiers
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0305397
Identifier Type: -
Identifier Source: org_study_id
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