MedTrace Logo

Effects of Serratus Posterior Superior Intercostal Plane Block and Pectoralis Nerve Block in Coronary Artery Surgery

NCT06242431 · Status: COMPLETED · Phase: NA · Type: INTERVENTIONAL · Enrollment: 68

Last updated 2025-01-28

No results posted yet for this study

Summary

Postoperative analgesia is a critical risk factor for the development of pulmonary and cardiovascular complications in all types of chest surgery, particularly coronary artery bypass graft (CABG) surgery. Patients with high levels of pain who cannot breathe effectively may experience atelectasis, cardiac ischemia, and arrhythmias. This prolongs hospitalization and increases the frequency of postoperative pulmonary complications and morbidity. If postoperative acute pain is not adequately treated, it may lead to the development of chronic pain, hindering patients from recovering normal activities for an extended period. In addition to medications, various neuroaxial and peripheral nerve blocks can be used in cardiac surgery.

The use of high-dose heparin during surgery, along with neuroaxial anesthesia (thoracic epidural and intrathecal opioids), is controversial. Thoracic paravertebral block (TPVB) has demonstrated efficacy and is considered a method with fewer potential side effects compared to thoracic epidural anesthesia. However, TPVB has become less preferred in cardiac surgery due to its sympathetic blockade. Recently, peripheral nerve blocks have gained popularity as alternatives. These blocks include pectoralis nerve blocks (PECS-I, PECS-II), serratus anterior plane block (SAPB), serratus posterior superior intercostal plane block (SPSIPB), erector spinae plane block (ESPB), transverse thoracic plane blocks (TTMP), pectointercostal-fascial blocks (PIF), and intercostal nerve blocks. These blocks are newer and more superficially located compared to TPVB. Additionally, these fascial blocks are considered safer in terms of side effects as they do not cause sympathetic blockade like TPVB.

The hypothesis of this study is that SPSIPB can provide more extensive dermatomal analgesia compared to PECS-II, resulting in more effective postoperative analgesia. Therefore, this study plans to compare the analgesic effects of ultrasound-guided SPSIPB and PECS-II block applications in patients undergoing coronary artery bypass surgery with sternotomy.

Conditions

  • Postoperative;Pain Management

Interventions

PROCEDURE

Group serratus posterior superior intercostal plane block (SPSIPB)

SPSIPB; The procedure will be carried out with the patient in the lateral decubitus position. After gently shifting the scapula laterally, the US probe is held sagittally at the upper corner of the scapula, and the 3rd rib and serratus posterior superior muscle are visualized. The block needle will be advanced in the cranio-caudal direction to enter between the serratus posterior superior and the 3rd rib. After confirming the block site, 30 ml of 0.25% concentration of marcaine (bupivacaine) will be used.

PROCEDURE

Group pectoralis nerve block (PECS-II)

PECS II; The block will be performed in the supine position of the patient, just anterior to the axillary line at the level of the 4th rib. After visualizing the serratus anterior, pectoralis major, and pectoralis minor muscles along with the ribs and pleura, the needle will be directed in-plane from cranial to caudal into the fascia of the serratus anterior muscle. Subsequently, 30 ml of bupivacaine with a 0.25% concentration will be applied.

Sponsors & Collaborators

  • Hitit University

    lead OTHER

Study Design

Allocation
RANDOMIZED
Purpose
SUPPORTIVE_CARE
Masking
SINGLE
Model
PARALLEL

Eligibility

Min Age
18 Years
Max Age
65 Years
Sex
ALL
Healthy Volunteers
No

Timeline & Regulatory

Start
2024-02-07
Primary Completion
2024-07-15
Completion
2024-08-27

Countries

  • Turkey (Türkiye)

Study Locations

More Related Trials

Read the full study record

This page highlights key information. For complete eligibility criteria, study locations, investigator contacts, and the full protocol, visit the original record on ClinicalTrials.gov.

View NCT06242431 on ClinicalTrials.gov