The Effect of Parasternal Block on Postoperative Pain in Patients Undergoing Coronary Artery Bypass Graft Surgery
Status:
COMPLETED
Trial end date:
2020-10-17
Target enrollment:
Participant gender:
Summary
Objective: This study aims to investigate the effects of intraoperative parasternal block on postoperative analgesia in patients undergoing elective coronary artery bypass graft surgery.
Materials and Methods: This prospective, randomized, double-blind study included 78 patients aged 30-80 years with an ASA (American Society of Anesthesiologists) risk score of III-IV, who were scheduled for elective coronary artery bypass graft surgery. Patients were randomly assigned into two groups: the parasternal block group (n = 39), receiving parasternal block with 2.5% bupivacaine, and the saline group (n = 39), receiving parasternal block with 0.9% NaCl. All patients were administered a standard anesthesia protocol, and routine care and analgesia practices during the postoperative period were not interfered with. Patients in the intensive care unit received intravenous paracetamol every 8 hours for analgesia. If postoperative 24-hour pain scores in the intensive care unit , assessed using the Behavioral Pain Scale while intubated and the Numeric Rating Scale while extubated, exceeded 4, 1 mg/kg tramadol was administered. The timing and doses of the first tramadol administration, as well as extubation times, intensive care unit stay durations, and discharge times, were recorded.
Results: In the postoperative period, Behavioral Pain Scale scores at the 8th hour and Numeric Rating Scale scores at the 4th and 12th hours were significantly lower in the parasternal block group compared to the saline group (p \< 0.005). The average extubation time was 8.76 hours in the parasternal block group and 14.76 hours in the saline group (p \< 0.001). Among patients with pain scores of 4 or higher, the total tramadol consumption in the parasternal block group was 150 64.72 mg, with the first tramadol administration occurring at 17.26 4.78 hours. In the saline group, total tramadol consumption was 212.5 82.23 mg, and the first administration occurred at 12.35 5.75 hours.
Conclusion: Our study demonstrated that parasternal block, as a component of multimodal analgesia, improved postoperative analgesia levels in coronary artery bypass graft surgery. Therefore, the investigators consider parasternal block to be effective in pain management following median sternotomy.