Parasternal Block Combined With Rectus Sheath Block for Cardiac Surgery Under Sternotomy

NCT ID: NCT05764616

Last Updated: 2023-11-27

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

58 participants

Study Classification

INTERVENTIONAL

Study Start Date

2023-03-21

Study Completion Date

2023-11-10

Brief Summary

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The aim of this randomized controlled trial is to examine the effect of ultrasound guided bilateral Parasternal Nerve Block combined with rectus sheath block on preoperative analgesia, opioid consumption and respiratory function in patients undergoing cardiac surgery via sternotomy. Half of participants will receive General Anesthesia combined with bilateral parasternal block and rectus sheath block while the other half receive General Anesthesia combined with bilateral parasternal block and infiltration of drainage exits sites with local anesthetic (without performing rectus sheath block)

Detailed Description

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Conditions

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Cardiac Disease Surgery Analgesia Acute Pain Postoperative Pain

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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RECTUS group

Patients will receive General Anesthesia combined with bilateral parasternal block and rectus sheath block

Group Type EXPERIMENTAL

PARASTERNAL BLOCK

Intervention Type PROCEDURE

After induction of general anesthesia, an ultrasound-guided Parasternal Block will be performed with 20 mL of ropivacaine 0.5 % per side.

RECTUS SHEATH BLOCK

Intervention Type PROCEDURE

At the end of surgery, a rectus sheath block will be performed with 10 mL of ropivacaine 0.25% per side.

CONTROL group

Patients will receive General Anesthesia combined with bilateral parasternal block and infiltration of drainage exits sites with local anesthetic

Group Type ACTIVE_COMPARATOR

PARASTERNAL BLOCK

Intervention Type PROCEDURE

After induction of general anesthesia, an ultrasound-guided Parasternal Block will be performed with 20 mL of ropivacaine 0.5 % per side.

LOCAL INFILTRATION OF DRAINAGE EXIT SITES

Intervention Type PROCEDURE

At the end of surgery, a local infiltration of drainage exit sites will be performed with 10 mL of ropivacaine 0.25% per side

Interventions

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PARASTERNAL BLOCK

After induction of general anesthesia, an ultrasound-guided Parasternal Block will be performed with 20 mL of ropivacaine 0.5 % per side.

Intervention Type PROCEDURE

LOCAL INFILTRATION OF DRAINAGE EXIT SITES

At the end of surgery, a local infiltration of drainage exit sites will be performed with 10 mL of ropivacaine 0.25% per side

Intervention Type PROCEDURE

RECTUS SHEATH BLOCK

At the end of surgery, a rectus sheath block will be performed with 10 mL of ropivacaine 0.25% per side.

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* Patients undergoing elective cardiac surgery under median sternotomy
* Age \>= 18 years
* American Society of Anesthesiologists (ASA) Status I-IV
* Approval and sign of the informed consent

Exclusion Criteria

* Allergy to local anesthetics
* Puncture site infection
* Lack of signing of informed consent
* Age \<18 years
* Emergency surgery
* ASA \> IV
* preoperative acute respiratory failure
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Campus Bio-Medico University

OTHER

Sponsor Role lead

Responsible Party

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Giuseppe Pascarella

Principal Investigator

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Giuseppe Pascarella, MD

Role: PRINCIPAL_INVESTIGATOR

University Hospital Campus Biomedico of Rome

Locations

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Campus Bio-medico University Hospital Foundation

Rome, , Italy

Site Status

Countries

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Italy

References

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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)

Barr AM, Tutungi E, Almeida AA. Parasternal intercostal block with ropivacaine for pain management after cardiac surgery: a double-blind, randomized, controlled trial. J Cardiothorac Vasc Anesth. 2007 Aug;21(4):547-53. doi: 10.1053/j.jvca.2006.09.003. Epub 2006 Dec 22.

Reference Type RESULT
PMID: 17678782 (View on PubMed)

Elbahrawy K, El-Deeb A. Rectus sheath block for postoperative analgesia in patients with mesenteric vascular occlusion undergoing laparotomy: A randomized single-blinded study. Anesth Essays Res. 2016 Sep-Dec;10(3):516-520. doi: 10.4103/0259-1162.179315.

Reference Type RESULT
PMID: 27746544 (View on PubMed)

Cibelli M, Brodier EA, Smith FG. Pectoralis-Intercostal-Rectus Sheath (PIRS) Plane Block With Catheters. A New Technique to Provide Analgesia in Cardiac Surgery. J Cardiothorac Vasc Anesth. 2020 Mar;34(3):846-847. doi: 10.1053/j.jvca.2019.09.014. Epub 2019 Sep 18. No abstract available.

Reference Type RESULT
PMID: 31590939 (View on PubMed)

Everett L, Davis TA, Deshpande SP, Mondal S. Implementation of Bilateral Rectus Sheath Blocks in Conjunction With Transversus Thoracis Plane and Pectointercostal Fascial Blocks for Immediate Postoperative Analgesia After Cardiac Surgery. Cureus. 2022 Jul 5;14(7):e26592. doi: 10.7759/cureus.26592. eCollection 2022 Jul.

Reference Type RESULT
PMID: 35936156 (View on PubMed)

Strumia A, Pascarella G, Sarubbi D, Di Pumpo A, Costa F, Conti MC, Rizzo S, Stifano M, Mortini L, Cassibba A, Schiavoni L, Mattei A, Ruggiero A, Agro FE, Carassiti M, Cataldo R. Rectus sheath block added to parasternal block may improve postoperative pain control and respiratory performance after cardiac surgery: a superiority single-blinded randomized controlled clinical trial. Reg Anesth Pain Med. 2025 Sep 4;50(9):712-718. doi: 10.1136/rapm-2024-105430.

Reference Type DERIVED
PMID: 38876800 (View on PubMed)

Other Identifiers

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PAR 06.23

Identifier Type: -

Identifier Source: org_study_id