Bilateral Transversus Thoracic Muscle Plane Block as Analgesic in Open Heart Surgeries by US.

• Status: Completed
• Trial end date: 2021-02-01
• Target enrollment: 0
• Participant gender: All

Summary

OPEN CARDIAC SURGERY may cause severe postoperative pain and promote a high risk of chronic pain if not treated adequately, that is caused by multiple factors; sternotomy, costotransverse and costovertebral joint distensions, opening of the pericardium, internal mammarian artery harvesting, surgical manipulation of the parietal pleura, chest tube insertion and other musculoskeletal trauma that occurs during surgery.

Adequate analgesia is important not only for patient comfort, but for weaning from ventilator and prevention of respiratory complications. Opioids are used to provide analgesia, but they are associated with significant side effects which include sedation, respiratory depression, nausea, and vomiting.

Severe sternotomy pain in cardiac surgery has been reported in up to 49% of patients at rest and 78% at movement. Of the various options for postoperative pain relief in cardiac surgery, we have chosen an ultrasound-guided transversus thoracic muscle plane (TTP) block versus sham block performed by the anesthesiologist.

Transversus thoracic muscle plane (TTP) block and The pecto-intercostal fascial plane block can block multiple anterior branches of the intercostal nerves (T2 to 6), which dominate the internal mammary region with a single injection bilaterally.

• Phase: Phase 4
• Accepts Healthy Volunteers?: Accepts Healthy Volunteers

Details

• Lead Sponsor: Fayoum University
• Treatments: Analgesics; Bupivacaine

Criteria

Inclusion Criteria:

• Patients 18 years of age or older (18 - 80 yrs. old).

• Scheduled for elective cardiac surgery for valve replacement or adult congenital (VSD or ASD) via median sternotomy.

Exclusion Criteria:

• Patients with emergency surgeries.

• Allergy to drug used.

• re-do surgery.

• Coagulopathy.

• Neuromuscular disease.

• Preoperative poor left ventricular function (EF < 35%).

• Systemic infections or infections at site of injection.

• Psychiatric illnesses (schizophrenia, bipolar, uncontrolled anxiety or depression).

• Narcotic dependency.