Ultrasound-Guided Pecto-Intercostal Fascial Block for Postoperative Pain Management in Cardiac Surgery: A Prospective, Randomized, Placebo-Controlled Trial.
J Cardiothorac Vasc Anesth
; 35(3): 896-903, 2021 Mar.
Article
in En
| MEDLINE
| ID: mdl-32798172
ABSTRACT
OBJECTIVE:
To explore the effect of pecto-intercostal fascial plane block (PIFB) on postoperative opioid requirements, pain scores, lengths of intensive care unit and hospital stays and incidence of postoperative delirium in cardiac surgical patients.DESIGN:
Single- center, prospective, randomized (11), quadruple- blinded, placebo-controlled trial.SETTING:
Single center, tertiary- care center.PARTICIPANTS:
The study comprised 80 adult cardiac surgical patients (age >18 y) requiring median sternotomy. INTERVENTION Patients were randomly assigned to receive ultrasound-guided PIFB, with either 0.25% bupivacaine or placebo, on postoperative days 0 and 1. MEASUREMENTS AND MAINRESULTS:
Of the 80 patients randomized, the mean age was 65.78 ± 8.73 in the bupivacaine group and 65.70 ± 9.86 in the placebo group (pâ¯=â¯0.573). Patients receiving PIFB with 0.25% bupivacaine showed a statistically significant reduction in visual analog scale scores (4.8 ± 2.7 v 5.1 ± 2.6; p < 0.001), but the 48-hour cumulative opioid requirement computed as morphine milligram equivalents was similar (40.8 ± 22.4 mg v 49.1 ± 26.9 mg; pâ¯=â¯0.14). There was no difference in the incidence of postoperative delirium between the groups evaluated using the 3-minute diagnostic Confusion Assessment Method (3/40 [7.5%] v 5/40 [12.5%] placebo; pâ¯=â¯0.45).CONCLUSION:
Patients who received PIFB with bupivacaine showed a decline in cumulative opioid consumption postoperatively, but this difference between the groups was not statistically significant. Low incidence of complications and improvement in visual analog scale pain scores suggested that the PIFB can be performed safely in this population and warrants additional studies with a larger sample size.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Cardiac Surgical Procedures
/
Nerve Block
Type of study:
Clinical_trials
/
Diagnostic_studies
/
Observational_studies
/
Risk_factors_studies
Limits:
Adult
/
Aged
/
Humans
/
Middle aged
Language:
En
Journal:
J Cardiothorac Vasc Anesth
Journal subject:
ANESTESIOLOGIA
/
CARDIOLOGIA
Year:
2021
Document type:
Article
Affiliation country: