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Comparison of Erector Spinae Plane Block (ESPB) With the Combination of Superficial Parasternal Intercostal Plane Block (SPIPB) and Serratus Anterior Plane Block (SAPB) in the Management of Postoperative Sternotomy Pain in Patients Undergoing Cardiac Surgery Via Sternotomy

ConditionsPostoperative PainSternotomy PainAcute PainCardiac SurgeryPain Management
Trial statusRecruiting
Trial phaseNot applicable
Trial typeInterventional
Biological sexAll
Age18-80
SponsorUludag University

About this trial

This study aims to compare the effectiveness of two regional anesthesia techniques in managing pain for participants undergoing cardiac surgery via sternotomy. The investigators will evaluate whether the Erector Spinae Plane Block (ESPB) or a combination of the Superficial Parasternal Intercostal Plane Block (SPIPB) and Serratus Anterior Plane Block (SAPB) provides better pain control and recovery outcomes.

Eligibility criteria

This trial does not accept healthy volunteers

Qualifiers

Patients aged between 18 and 80 years.

Patients classified as American Society of Anesthesiologists (ASA) physical status I, II, or III.

Patients scheduled for elective cardiac surgery via median sternotomy.

Patients who have provided written informed consent.

Disqualifiers

Pregnancy or suspected pregnancy.

Body Mass Index (BMI) > 35 kg/m².

Known allergy or hypersensitivity to local anesthetics (e.g., bupivacaine).

Suspected coagulopathy or bleeding disorders.

Trial design

Design model

Parallel

Treatments tested in this trial

  • Erector spinae plane block (ESPB)

    Procedure/Surgery

    Bilateral ultrasound-guided ESPB is performed at the T4 or T5 vertebral level. Following skin preparation and visualization of the transverse process and erector spinae muscle, a block needle is inserted. After confirming the needle tip position between the muscle and the transverse process, 0.5 mL/kg of 0.25% Bupivacaine is injected on each side.

  • Superficial Parasternal Intercostal Plane Block (SPIPB)

    Procedure/Surgery

    Bilateral ultrasound-guided SPIPB is performed. 0.25% Bupivacaine is administered. This is part of a combined regional analgesia technique for sternotomy.

  • Serratus Anterior Plane Block (SAPB)

    Procedure/Surgery

    Bilateral ultrasound-guided SAPB is performed. 0.25% Bupivacaine is administered. This is part of a combined regional analgesia technique for the chest wall.

Treatment groups

50 Participants
are divided into 2 treatment groups
Group A: Erector Spinae Plane Block GroupActive comparator 1 intervention
Group B: SPIPB and SAPB GroupActive comparator 2 interventions

Trial outcomes

Primary outcomes

1

Pain Intensity (Visual Analog Scale Score)

Pain levels assessed using the Visual Analog Scale (0 = no pain, 10 = worst imaginable pain).

Time frame
At 0, 1, 2, 4, 8, 12, 16 and 24 hours postoperatively.

Secondary outcomes

1

Extubation Time

The duration from the end of the surgical procedure until the patient is successfully extubated.

Time frame
From the end of surgery until the date of successful endotracheal tube removal, assessed up to 24 hours.
2

Total Postoperative Opioid Consumption

Total amount of opioid (e.g., morphine or fentanyl) administered to the patient in the first 24 hours.

Time frame
From the end of surgery up to 24 hours postoperatively.
3

Behavioral Pain Scale (BPS)

Pain assessment based on facial expression, upper limb movement, and compliance with ventilation.

Time frame
From ICU admission until extubation, assessed up to 24 hours.
4

Time to First Rescue Analgesic

The time elapsed from the end of surgery until the patient first requires additional pain medication.

Time frame
From the end of surgery until the first dose of rescue analgesic, assessed up to 24 hours.

Other outcomes

Sponsors and contacts

Click on the lead sponsor to view all of their trials.

Uludag University

Lead sponsor

Source ClinicalTrials.gov
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