Parasternal and Adductor Canal Blocks in CABG

Официальное название

Comparison of Postoperative Analgesic Efficacy of Parasternal Block and Parasternal Block Combined With Adductor Canal Block in Coronary Artery Bypass Graft Surgery: A Randomized Controlled Trial

Обзор

This randomized controlled trial evaluates the effectiveness of different postoperative analgesic strategies in patients undergoing coronary artery bypass graft (CABG) surgery. Patients were allocated into three groups receiving either conventional analgesia alone, parasternal block in addition to conventional analgesia, or combined parasternal and adductor canal blocks with conventional analgesia. The study aims to compare postoperative pain scores, opioid consumption, and recovery outcomes among the groups in order to determine whether the addition of regional anesthesia techniques, particularly the combined block approach, provides superior analgesia and enhances postoperative recovery following CABG surgery.

Вмешательства

• Процедура parasternal block
  Ultrasound-guided parasternal block was performed bilaterally after induction of general anesthesia in patients undergoing coronary artery bypass graft surgery. Following aseptic skin preparation, a high-frequency linear ultrasound probe was placed parallel to the sternum to identify the parasternal intercostal plane. A block needle was advanced under ultrasound guidance, and local anesthetic was injected into the interfascial plane adjacent to the sternum to provide anterior thoracic wall analg
• Процедура Parasternal block + Adductor canal block
  In addition to conventional analgesia, patients received ultrasound-guided bilateral parasternal block and adductor canal block after induction of general anesthesia. The parasternal block was performed by injecting local anesthetic into the interfascial plane adjacent to the sternum under ultrasound guidance to provide anterior thoracic wall analgesia. The adductor canal block was performed under ultrasound guidance by depositing local anesthetic within the adductor canal to provide analgesia a
• Другое conventional analgesic regimen
  Patients received standard postoperative analgesia consisting of intravenous patient-controlled analgesia (PCA) with morphine following coronary artery bypass graft surgery. The PCA device was initiated in the postoperative period according to institutional analgesia protocols, allowing patient-administered morphine dosing for pain control. Additional rescue analgesics were administered when clinically indicated.

Первичные конечные точки

• Postoperative opioid consumption [Срок оценки: At postoperative 0,1, 2, 4, 8, 12, 24, 48, and 72 hours; total morphine consumption at 72 hours]

Вторичные конечные точки (3)

• Postoperative pain scores assessed using the Numeric Rating Scale (NRS) [Срок оценки: At postoperative 0, 1, 2, 4, 8, 12, 24, 48, and 72 hours]
• Quality of Recovery-15 (QoR-15) score [Срок оценки: At postoperative 24 and 72 hours]
• Postoperative nausea and vomiting and antiemetic consumption [Срок оценки: At postoperative 0, 1, 2, 4, 8, 12, 24, 48, and 72 hours]

Критерии участия

Критерии включения

• Patients aged 18-80 years Patients classified as American Society of Anesthesiologists (ASA) physical status II-IV Patients scheduled for elective coronary artery bypass graft (CABG) surgery under general anesthesia Patients undergoing saphenous vein graft harvesting during CABG surgery Patients able to understand and use the Numeric Rating Scale (NRS) and Quality of Recovery-15 (QoR-15) questionnaire Patients who provided written informed consent to participate in the study

Критерии исключения

• Patient refusal to participate in the study Known allergy or hypersensitivity to local anesthetics, morphine, or study-related medications Emergency coronary artery bypass graft surgery History of chronic opioid use or opioid dependence Pre-existing chronic pain syndromes requiring regular analgesic treatment Cognitive impairment or inability to understand the Numeric Rating Scale (NRS) or Quality of Recovery-15 (QoR-15) questionnaire Coagulopathy or ongoing anticoagulant therapy contraindicating regional anesthesia techniques Local infection at the planned block sites Severe hepatic or renal dysfunction Previous surgery or anatomical abnormality preventing performance of the regional blocks Conversion to a surgical procedure other than planned CABG during the intraoperative period Hemodynamic instability requiring mechanical circulatory support or reoperation in the early postoperative period Patients requiring prolonged postoperative mechanical ventilation or deep sedation preventing postoperative pain assessment

Критерии приведены из реестра в оригинале (на английском). Окончательную оценку соответствия проводит исследовательский центр.

Здоровые добровольцы: Нет

Дизайн исследования

Распределение

Рандомизированное

Модель

Параллельные группы

Маскирование

Двойное слепое

Основная цель

Профилактика

Центры проведения

Turkey (Türkiye) · 1 центр

• Zonguladk Bulent ecevit University — Zonguldak

Идентификаторы

NCT: NCT07599748 · AEŞH-EK-2026-053

Первоисточники (государственные реестры)

• ClinicalTrials.gov (NIH, США)

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