Adductor Canal Block: Efficacy in Postoperative Pain Management for Cardiac Surgery

Официальное название

Effectiveness of Adductor Canal Block in Postoperative Co-analgesia for Cardiac Surgery With Saphenous Vein Harvesting

Обзор

Adductor Canal Block: Efficacy in Postoperative Pain Management for Cardiac Surgery

Вмешательства

• Процедура Aductor canal bloc
  Adductor canal bloc with 0,25% bupivacaine + 20 ucg of dexmedetomidine
• Процедура Control adductor canal block
  Needle insertion mimicking the ACB procedure with injection of a saline solution

Первичные конечные точки

• Leg Pain at Rest [Срок оценки: Numeric rating scale (NRS 0-10) will be performed at 3 hours, 6 hours, 12 hours, and 24 hours after the block injection.]

Вторичные конечные точки (9)

• Total opioid consumption [Срок оценки: The first 48 postoperative hours after procedure]
• Postoperative pain unrelated to the saphenous territory [Срок оценки: Numeric rating scale (NRS 0-10) performed at 3 hours, 6 hours, 12 hours, and 24 hours after the block injection.]
• Persistent Postoperative Pain [Срок оценки: At 3 and 6 months postoperatively, assessed using the NRS.]
• Overall persistent postoperative pain [Срок оценки: At 3 and 6 months postoperatively.]
• Presence of hypoesthesia [Срок оценки: Numeric rating scale at 3 and 6 months.]
• Neuropathic characterization [Срок оценки: At 48 hours, 3 months, and 6 months.]
• Block safety [Срок оценки: Assessed daily during hospitalization until patient is discharge from the hospital (an average of 7 days), up to 60 days.]
• Opioid-related side effects [Срок оценки: Each time the patient takes opioids during in the postoperative period until discharge from the hospital (an average of 7 days), up to 60 days.]
• Time to extubation [Срок оценки: At extubation]

Критерии участия

Критерии включения

• Planned CABG with unilateral or bilateral great saphenous vein (GSV) harvesting, without concomitant valve surgery
• Age ≥ 18 years
• Ability to understand the protocol and provide written informed consent
• ASA physical status I-IV

Критерии исключения

• Refusal to participate in the study or inability to provide written informed consent
• Contraindication to adductor canal block (e.g., local infection, allergy to local anesthetics)
• Pre-existing chronic pain associated with chronic use of analgesic medications other than acetaminophen
• Pre-existing peripheral neuropathy affecting the leg
• Participation in two other interventional studies at the Montreal Heart Institute
• Endoscopic vein harvesting performed by the surgical team instead of open saphenectomy technique

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

Тройное слепое

Основная цель

Профилактика

Центры проведения

Канада · 1 центр

• Montreal Heart Institute — Montreal

Публикации

• El Tallawy SN, Ali WA, Thallaj AK, Ahmed RS, Manaa EM, Mostafa MS, Aljasser FF, Amlih HF, Hassanin AA. Comparative study between surgical wound catheter, femoral nerve block, and adductor canal block for postoperative analgesia after knee arthroplasty: A double blind randomized clinical trial. Saudi J Anaesth. 2023 Jul-Sep;17(3):359-367. doi: 10.4103/sja.sja_894_22. Epub 2023 Mar 15. PMID 37601506
• Moon, N., & Lin, E. (2025, May 23). Adductor canal block. OpenAnesthesia. https://www.openanesthesia.org/keywords/adductor-canal-block
• Moradian ST, Najafloo M, Mahmoudi H, Ghiasi MS. Early mobilization reduces the atelectasis and pleural effusion in patients undergoing coronary artery bypass graft surgery: A randomized clinical trial. J Vasc Nurs. 2017 Sep;35(3):141-145. doi: 10.1016/j.jvn.2017.02.001. PMID 28838589
• Grant MC, Crisafi C, Alvarez A, Arora RC, Brindle ME, Chatterjee S, Ender J, Fletcher N, Gregory AJ, Gunaydin S, Jahangiri M, Ljungqvist O, Lobdell KW, Morton V, Reddy VS, Salenger R, Sander M, Zarbock A, Engelman DT. Perioperative Care in Cardiac Surgery: A Joint Consensus Statement by the Enhanced Recovery After Surgery (ERAS) Cardiac Society, ERAS International Society, and The Society of Thora PMID 38284956
• Fujita Y, Mera H, Watanabe T, Furutani K, Kondo HO, Wakai T, Kawashima H, Ogose A. Significantly earlier ambulation and reduced risk of near-falls with continuous infusion nerve blocks: a retrospective pilot study of adductor canal block compared to femoral nerve block in total knee arthroplasty. BMC Musculoskelet Disord. 2022 Aug 12;23(1):768. doi: 10.1186/s12891-022-05735-6. PMID 35953812
• Al Wahbi AM. Evaluation of pain during endovenous laser ablation of the great saphenous vein with ultrasound-guided femoral nerve block. Vasc Health Risk Manag. 2017 Aug 10;13:305-309. doi: 10.2147/VHRM.S135308. eCollection 2017. PMID 28860790
• Li YH, Wang T, Qian C, Chen GP, Lou WS, Gu JP. Application of Femoral Nerve Block in Treating Great Saphenous Vein Insufficiency by Endovenous Radiofrequency Ablation Combined with Punctate Stripping. Clin Appl Thromb Hemost. 2023 Jan-Dec;29:10760296231220054. doi: 10.1177/10760296231220054. PMID 38130118
• Dzieciuchowicz L, Espinosa G, Grochowicz L. Evaluation of ultrasound-guided femoral nerve block in endoluminal laser ablation of the greater saphenous vein. Ann Vasc Surg. 2010 Oct;24(7):930-4. doi: 10.1016/j.avsg.2009.10.022. Epub 2010 Jul 3. PMID 20598852

Идентификаторы

NCT: NCT07732465 · 2026-3693 MHI

Первоисточники (государственные реестры)

• ClinicalTrials.gov (NIH, США)

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