This work aims to assess the analgesic efficacies of transversus thoracic muscle plane block (TTPB) and transversus thoracic muscle plane block (TTPB) for open cardiac surgeries
Age from 40 to 60 years.
Both sexes.
American Society of Anesthesiology (ASA) physical status II-III.
Body mass index (BMI) < 35 kg/m2.
Valve replacement procedures.
Emergency operations.
Redo surgeries.
Minimally invasive approaches.
Parallel
Pecto-intercostal fascial block
Other interventionPatients will receive pecto-intercostal fascial block intraoperatively (20 ml of bupivacaine 0.25% + 1 ml dexamethasone 8 mg).
Transversus thoracic muscle plane block
Other interventionPatients will receive transversus thoracic muscle plane block was performed intraoperatively (20 ml of bupivacaine 0.25% + 1 ml dexamethasone 8 mg).
Sham (No Treatment)
Other interventionPatients will receive bilateral superficial needle puncture at a location like transversus thoracic muscle plane block without any solution injected. Only 25 saline will be injected superficially.
Total amount analgesic requirement
In cases where rescue analgesia is required \[numerical rating scale (NRS) ≥4\], intravenous Nalbuphine 0.1 mg/kg will be given.
Degree of pain
Degree of pain will be assessed using Numerical rating scale (NRS) from 0 (no pain) to 10 (worst severe pain). NRS will be measured at 2h, 4h, 8h, 16h and 24h after surgery.
The number of patients required rescue analgesia
The number of patients requires rescue analgesic will be recorded at 0, 3, 6, 12, 18, and 24 hours after extubation.
Postoperative nausea and vomiting (PONV)
The patients will be verbally evaluated according to a descriptive five-point postoperative nausea and vomiting (PONV) scale at 0, 3, 6, 12, 18, and 24 hours after the extubation. If a score of 3 or more is registered, ondansetron 4 mg IV will be administered and repeated after 8 hours if required. The PONV scale is 0 = no nausea; 1 = slight nausea; 2 = moderate nausea; 3 = vomiting once; and 4 = vomiting more than once.
Time to extubation
After the operation, the time until the patient is extubated will be recorded.
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