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Ultrasound Guided Parasternal Block for Perioperative Analgesia in Cardiac Surgery: A Prospective Study.
Pascarella, Giuseppe; Costa, Fabio; Nonnis, Giulia; Strumia, Alessandro; Sarubbi, Domenico; Schiavoni, Lorenzo; Di Pumpo, Annalaura; Mortini, Lara; Grande, Stefania; Attanasio, Andrea; Gadotti, Giovanni; De Cassai, Alessandro; Mattei, Alessia; Nenna, Antonio; Chello, Massimo; Cataldo, Rita; Agrò, Felice Eugenio; Carassiti, Massimiliano.
Afiliación
  • Pascarella G; Unit of Anaesthesia and Intensive Care, Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Rome, Italy.
  • Costa F; Unit of Anaesthesia and Intensive Care, Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Rome, Italy.
  • Nonnis G; Unit of Anaesthesia and Intensive Care, Ospedale dei Castelli, Ariccia, 00040 Rome, Italy.
  • Strumia A; Unit of Anaesthesia and Intensive Care, Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Rome, Italy.
  • Sarubbi D; Unit of Anaesthesia and Intensive Care, Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Rome, Italy.
  • Schiavoni L; Unit of Anaesthesia and Intensive Care, Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Rome, Italy.
  • Di Pumpo A; Unit of Anaesthesia and Intensive Care, Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Rome, Italy.
  • Mortini L; Unit of Anaesthesia and Intensive Care, Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Rome, Italy.
  • Grande S; Unit of Anaesthesia and Intensive Care, Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Rome, Italy.
  • Attanasio A; Unit of Anaesthesia and Intensive Care, Ospedale Sant Orsola, 40138 Bologna, Italy.
  • Gadotti G; Unit of Anaesthesia and Intensive Care, Azienda Ospedaliera San Camillo Forlanini, 00152 Rome, Italy.
  • De Cassai A; Unit of Anaesthesia and Intensive Care, University Hospital of Padua, 35128 Padua, Italy.
  • Mattei A; Unit of Anaesthesia and Intensive Care, Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Rome, Italy.
  • Nenna A; Unit of Cardiac Surgery, Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Rome, Italy.
  • Chello M; Unit of Cardiac Surgery, Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Rome, Italy.
  • Cataldo R; Unit of Anaesthesia and Intensive Care, Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Rome, Italy.
  • Agrò FE; Unit of Anaesthesia and Intensive Care, Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Rome, Italy.
  • Carassiti M; Unit of Anaesthesia and Intensive Care, Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Rome, Italy.
J Clin Med ; 12(5)2023 Mar 06.
Article en En | MEDLINE | ID: mdl-36902846
ABSTRACT
Ultrasound guided parasternal block is a regional anaesthesia technique targeting the anterior branches of intercostal nerves, which supply the anterior thoracic wall. The aim of this prospective study is to assess the efficacy of parasternal block to manage postoperative analgesia and reduce opioid consumption in patients undergoing cardiac surgery throughout sternotomy. A total of 126 consecutive patients were allocated to two different groups, receiving (Parasternal group) or not (Control group) preoperative ultrasound guided bilateral parasternal block with 20 mL of 0.5% ropivacaine per side. The following data were recorded postoperative pain expressed by a 0-10 numeric rating scale (NRS), intraoperative fentanyl consumption, postoperative morphine consumption, time to extubation and perioperative pulmonary performance at incentive spirometry. Postoperative NRS was not significantly different between Parasternal and Control groups with a median (IQR) of 2 (0-4.5) vs. 3 (0-6) upon awakening (p = 0.07); 0 (0-3) vs. 2 (0-4) at 6 h (p = 0.46); 0 (0-2) vs. 0 (0-2) at 12 h (p = 0.57). Postoperative morphine consumption was similar among groups. However, intraoperative fentanyl consumption was significantly lower in the Parasternal group [406.3 ± 81.6 mcg vs. 864.3 ± 154.4, (p < 0.001)]. Parasternal group showed shorter times to extubation [(191 ± 58 min vs. 305 ± 72 min, (p)] and better performance at incentive spirometer with a median (IQR) of 2 raised balls (1-2) vs. 1 (1-2) after awakening (p = 0.04). Ultrasound guided parasternal block provided an optimal perioperative analgesia with a significant reduction in intraoperative opioid consumption, time to extubation and a better postoperative performance at spirometry when compared to the Control group.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Tipo de estudio: Observational_studies Idioma: En Revista: J Clin Med Año: 2023 Tipo del documento: Article País de afiliación: Italia

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Tipo de estudio: Observational_studies Idioma: En Revista: J Clin Med Año: 2023 Tipo del documento: Article País de afiliación: Italia
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