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Postoperative pain after cardiac surgery is associated with reduced postoperative respiratory function. There is an association between greater pain and more pronounced decreases in lung volumes postoperatively. With an incidence of 10% to 25% of cases, pulmonary complications are the second source of postoperative morbidity after cardiac complications; in 2-5% of cases, the dysfunction is severe and leads to significant consequences that can lead to death. It has been shown that postoperative pain after cardiac surgery is associated with a reduction in functional respiratory capacity. There is an association between greater pain and more pronounced decreases in lung volumes postoperatively. The main objective of this study will be to evaluate the impact of locoregional anesthesia by parasternal block analgesic on postoperative respiratory function at D1 postoperatively
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| interventional arm | Experimental | the experimental arm will receive the parasternal block with injection of locoregional anesthesia |
|
| control arm not requiring loco-regional anesthesia. | Active Comparator | the control arm will receive a standard treatment, without locoregional anesthesia |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| parasternal block | Drug | Echo-guided loco-regional anesthesia by bilateral parasternal block in immediate preoperative. The drug used is Ropivacaine 2mg/ml, 0.2%. Injection of 20ml per side, under ultrasound control, after general anaesthesia and before skin incision, and therefore before surgery |
| Measure | Description | Time Frame |
|---|---|---|
| Change in postoperative forced vital capacity (FVC) | The primary endpoint was the change (reduction) in postoperative forced vital capacity (FVC) between the preoperative measurement and at D1 postoperatively.
| 1 day |
| Measure | Description | Time Frame |
|---|---|---|
| Variation of FCV between both groups | Respiratory functional investigations at day 2 is forced vital capacity (FVC) | at day 2 |
| Variation of FCV between both groups | Respiratory functional investigations at 1 month is forced vital capacity (FVC) |
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Inclusion Criteria:
Exclusion Criteria:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| CHU Amiens-Picardie | Amiens | 80054 | France |
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|
| Standard pain management | Drug | Standard pain management care involves a multimodal strategy that includes the use of intravenous analgesics. Morphine medications are the mainstay of pain management |
|
| at 1 month |
| Variation of FCV between both groups | Respiratory functional investigations at 3 months is forced vital capacity (FVC) | at 3 months |
| Variation of forced expiratory volume in 1 second (FEV1) | Respiratory functional investigations at day 2 are forced expiratory volume in 1 second (FEV1) | at day 2 |