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This clinical trial compares analgesia efficiency and recovery outcomes between two different fascial plane block techniques (ESPB vs.PIFB) in cardiac surgery patients participant population/health conditions].
The main questions it aims to answer are:
Regional nerve blocks, including Pecto-intercostal block (PIFB) and Erector spinae plane block (ESPB), can provide a certain level of analgesia for thoracic and cardiac surgeries. This study focuses on patients undergoing their first conventional sternotomy for cardiac surgery. They are randomly assigned to receive either PIFB or ESPB for pain relief. Comparisons are made between the two groups for postoperative 48-hour analgesic medication requirements, static and dynamic postoperative pain scores, improvements in postoperative respiratory function, quality of life index (QoL15), and other clinically relevant prognostic indicators.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Group E | Experimental | Patients who receive erector spinae plane block(ESPB) before cardiac surgery |
|
| Group P | Active Comparator | Patients who receive Pecto-intercostal plane block(PIFB) before cardiac surgery |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Erector spinae plane block (ESPB) | Procedure | Bilateral ESP: 0.5% ropivacaine 0.3 ml per kg (ideal body weight) each side, 30 min before skin excision. After surgery, use pump to deliver an intermittent automatic bolus of 0.3 ml per kg 0.16% ropivacaine every 4 hours each side. |
| Measure | Description | Time Frame |
|---|---|---|
| 48hr opioid consumption | The primary outcome of this study was the total oral morphine equivalent (OME) dose received within 48 hours after surgery. OME was calculated using a conversion toolkit within our hospital's electronic medical record system, which standardizes opioid analgesic doses to oral morphine equivalents according to established guidelines | Day 2 |
| Measure | Description | Time Frame |
|---|---|---|
| Postoperative static pain scores-Day 1 | Pain score reported by patients when resting | Day 1 |
| Postoperative static pain scores-Day 2 | Pain score reported by patients when resting |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Yi-Ting Chang, Dr. | Contact | (+886)4-23592525 | 4101 | taco@vghtc.gov.tw |
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Taichung Veterans General Hospital | Recruiting | Taichung | Taiwan | 407 | Taiwan |
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| ID | Term |
|---|---|
| D000377 | Agnosia |
| ID | Term |
|---|---|
| D010468 | Perceptual Disorders |
| D019954 | Neurobehavioral Manifestations |
| D009461 | Neurologic Manifestations |
| D009422 | Nervous System Diseases |
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| Pecto-intercostal fascial plane blok (PIFB) | Procedure | Bilateral PIFB: 0.5% ropivacaine 0.3 ml per kg (ideal body weight) each side, 30 min before skin excision. After surgery, use pump to deliver an intermittent automatic bolus of 0.3 ml per kg 0.16% ropivacaine every 4 hours each side. |
|
| Day 2 |
| Postoperative dynamic pain scores-Day 1 | Pain score reported by patients when mobilizing or deep coughing | Day 1 |
| Postoperative dynamic pain scores-Day 2 | Pain score reported by patients when mobilizing or deep coughing | Day 2 |
| postoperative incentive spirometry volume (ml)-Day 1 | daily volume of incentive spirometry | Day 1 |
| postoperative incentive spirometry volume (ml)-Day 2 | daily volume of incentive spirometry | Day 2 |
| postoperative incentive spirometry volume (ml)-Day 3 | daily volume of incentive spirometry | Day 3 |
| QoL15 (POD3) | quality of life questionnaire (QoL15) at postoperative day 3 | Day 3 |
| Serum cytokine (IL-6, IL-8, IL-10) - baseline | Baseline serum inflammatory cytokine, collected from the arterial line and the central venous line after induction of general anesthesia | During surgery (at the time the induction phase was completed, patients were under general anesthesia, and both arterial line and central venous line were in place) |
| Serum cytokine (IL-6, IL-8, IL-10)- aortic declamp | Serum inflammatory cytokines were collected after the aorta was declamped from both the arterial and central venous lines. | Within 10 min after the aortic declamping |
| Serum cytokine (IL-6, IL-8, IL-10)- 6hrs after aortic decalmped | Serum inflammatory cytokines were collected 6 hours after the aorta was declamped from both the arterial and central venous lines. | 6 hours after the aorta was declamped |
| Serum cytokine (IL-6, IL-8, IL-10)-24 hrs after surgery | Serum levels of inflammatory cytokines were collected 24 hours after surgery from both the arterial and central venous lines. | 24 hours after the surgery |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |