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The aim of the present study is to evaluate the effects of the recto-intercostal fascial plane block (RIFPB) or the rectus sheath block (RSB) combined with the pectoral-intercostal fascial plane block (PIFPB) on postoperative analgesia in patients undergoing cardiac surgery.
Effective pain management after cardiac surgery is crucial in improving patient outcomes, promoting early postoperative mobilisation and minimising the risk of postoperative respiratory complications. It has indeed been shown that these patients experience moderate to severe pain during the postoperative period. While opioids are commonly used in perioperative care, they are also linked to adverse opioid-related effects. The literature suggests selecting an analgesic treatment strategy that avoids opioid-based analgesia for patients undergoing cardiac surgery during the postoperative period. Regional anaesthesia techniques are widely used in cardiac surgery patients to address concerns about the risk of myocardial and/or renal damage associated with non-steroidal anti-inflammatory drugs (NSAIDs), reduce the incidence of potential opioid-related side effects, lower the high risk of delirium and improve patient rehabilitation. However, only a limited number of studies have demonstrated the effects of the recto-intercostal fascial plane block (RIFPB) or the rectus sheath block (RSB) combined with the pectoral-intercostal fascial plane block (PIFPB) on postoperative analgesia in cardiac surgery patients. Therefore, the present study aims to evaluate the effects of the RIFPB or the RSB combined with the PIFPB on postoperative analgesia in patients undergoing cardiac surgery.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| PIFPB+RIFPB |
| ||
| PIFPB+RSB |
| ||
| Control |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| PIFPB + RIFPB | Other | The procedure is performed under ultrasound guidance in a separate regional anaesthesia room during the preoperative period, under standard ASA monitoring. |
|
| Measure | Description | Time Frame |
|---|---|---|
| postoperative opioid consumption | 48 hours |
| Measure | Description | Time Frame |
|---|---|---|
| postoperative recovery quality | TThe Quality of Recovery-15 (QoR-15) is a 15-question questionnaire validated to assess poetoperative recovery. This questionnaire assesses patients' pain, physical comfort, physical independence, psychological support, and emotional status in the erly postoperative period. The patient is asked to express their status scoring from 0 to 10; therefore, the total score ranges from 0 to 150 points. |
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Inclusion Criteria:
Exclusion Criteria:
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It is planned to include ASA score I-IIII adult patients who are scheduled to elective cardiac surgery
| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Arzu Karaveli | Contact | +905325611300 | arzukaraveli@hotmail.com |
| Name | Affiliation | Role |
|---|---|---|
| Arzu Karaveli | University of Health Sciences, Antalya Training and Research Hospital | Principal Investigator |
| Ceren Nida Kural | University of Health Sciences, Antalya Training and Research Hospital | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| University of Health Sciences, Antalya Training and Research Hospital | Recruiting | Antalya | Turkey (Türkiye) |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 35900740 | Background | Grant MC, Gregory AJ, Ouanes JP. Regional analgesia for cardiac surgery. Curr Opin Anaesthesiol. 2022 Oct 1;35(5):605-612. doi: 10.1097/ACO.0000000000001169. Epub 2022 Jul 27. | |
| 38836555 | Background | Ciftci B, Omur B, Alver S, Akin AN, Yildiz Y, Tulgar S. The Medipol Combination: Novel Rectointercostal Fascial Plane Block and Pectointercostal Fascial Plane Block for Postoperative Analgesia Management After Cardiac Surgery: A Report of 15 Cases. A A Pract. 2024 Jun 5;18(6):e01794. doi: 10.1213/XAA.0000000000001794. eCollection 2024 Jun 1. |
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| PIFPB + RSB | Other | The procedure is performed under ultrasound guidance in a separate regional anaesthesia room during the preoperative period, under standard ASA monitoring. |
|
| Control | Other | Regional anesthesia is not applied. |
|
| 24 hours |
| postoperative pain scores | The NRS score (0=no pain; 10=most severe pain) will be used to assess postoperative pain | 48 hours |
| chronic pain | Patients will be telephoned 3 months after the operation and the presence, localization, and intensity of the pain, its character, and its relation with rest and/or activity will be recorded by asking only verbally. The NRS score (0=no pain; 10=most severe pain) will be used to assess postoperative pain. | 3 months |