Adductor Canal Block: Efficacy in Postoperative Pain Management for Cardiac Surgery

Leg Pain at Rest

The primary outcome will be leg pain at rest, measured using a numeric rating scale (NRS 0-10) at 3 hours, 6 hours, 12 hours, and 24 hours after the block injection. The NRS (Numeric Rating Scale) is a validated and widely used tool for assessing pain intensity in adults, particularly in postoperative and critical care settings. It allows for a simple, reproducible, and easily administered measurement, including during repeated assessments at the patient's bedside. The NRS scale consists of asking the patient to rate their pain on a numeric scale from 0 to 10, where: 0 corresponds to no pain at all 10 corresponds to the worst pain imaginable

Total opioid consumption

Cumulative amount administered, expressed in morphine milligram equivalents (MME), during the first 48 postoperative hours (conversion factors used: hydromorphone 1 mg = morphine 5 mg; fentanyl 100 µg = morphine 10 mg).

Postoperative pain unrelated to the saphenous territory

Incidence and characterization of postoperative pain unrelated to the saphenous territory (e.g., thoracic or musculoskeletal pain), assessed at the same time points as saphenous pain using a numeric rating scale (NRS 0-10). The NRS (Numeric Rating Scale) is a validated and widely used tool for assessing pain intensity in adults, particularly in postoperative and critical care settings. It allows for a simple, reproducible, and easily administered measurement, including during repeated assessments at the patient's bedside. The NRS scale consists of asking the patient to rate their pain on a numeric scale from 0 to 10, where: 0 corresponds to no pain at all 10 corresponds to the worst pain imaginable

Persistent Postoperative Pain

Proportion of patients reporting pain ≥4/10 at the harvest site at 3 and 6 months postoperatively, assessed using the NRS. The NRS (Numeric Rating Scale) is a validated and widely used tool for assessing pain intensity in adults, particularly in postoperative and critical care settings. It allows for a simple, reproducible, and easily administered measurement, including during repeated assessments at the patient's bedside. The NRS scale consists of asking the patient to rate their pain on a numeric scale from 0 to 10, where: 0 corresponds to no pain at all 10 corresponds to the worst pain imaginable

Overall persistent postoperative pain

Proportion of patients reporting pain ≥4/10 (all sites combined) at 3 and 6 months postoperatively. The NRS (Numeric Rating Scale) is a validated and widely used tool for assessing pain intensity in adults, particularly in postoperative and critical care settings. It allows for a simple, reproducible, and easily administered measurement, including during repeated assessments at the patient's bedside. The NRS scale consists of asking the patient to rate their pain on a numeric scale from 0 to 10, where: 0 corresponds to no pain at all 10 corresponds to the worst pain imaginable

Use of co-analgesia

Number of treatments used and frequency of use (lidocaine-ketamine cream, NSAIDs, gabapentinoids, etc.)

Postoperative quality of life

EQ-5D score quantification measured at 3 and 6 months postoperatively. The EQ-5D (EuroQol - 5 Dimensions) is a standardized and validated instrument used to assess health-related quality of life across two components. It is widely used in clinical research to measure the overall impact of a medical intervention on patients' functional status and well-being. It explores five dimensions of health: * Mobility * Self-care * Usual activities * Pain / discomfort * Anxiety / depression Each dimension is assessed across 5 levels of severity: * No problems * Slight problems * Moderate problems * Severe problems * Extreme problems / inability The combination of responses generates a 5-digit health profile, which can be converted into an EQ-5D index. 1.0: Represents perfect health. 0.0: Represents a state considered equivalent to death. Negative values: Health states deemed "worse than death."

Opioid use

Opioid use at 3 and 6 months postoperatively, assessed by the presence or absence of opioid use and the type of opioid used.