Comparing Two Regional Anesthesia Techniques for Pain Relief After Sternotomy in Cardiac Surgery A Study of Transversus Thoracic Plane Plus Serratus Anterior Plane Block Versus Erector Spinae Plane Block

What this Trial Is About

Researchers are investigating two regional anesthesia techniques to manage pain after cardiac surgery through median sternotomy. The study compares the combined Transversus Thoracic Plane Block TTPB and Serratus Anterior Plane Block SAPB versus the Erector Spinae Plane Block ESPB. This prospective, randomized trial includes 50 adult patients aged 18 to 80 with ASA physical status I to III undergoing elective cardiac surgery. The goal is to find which technique better controls postoperative pain while reducing opioid use and related side effects. Participants are randomly assigned to receive either the TTPBSAPB combination or the ESPB, both performed under ultrasound guidance after anesthesia induction and before surgery. During surgery, hemodynamic parameters are monitored, and rescue fentanyl is given if needed. Postoperatively in the ICU, all patients receive multimodal analgesia with intravenous paracetamol and tenoxicam. Pain is assessed using the Behavioral Pain Scale while intubated and the Visual Analog Scale after extubation, with rescue analgesics provided based on scores. Secondary measures include time to extubation, first mobilization, clinical transport, and patient and surgeon satisfaction. Throughout the study, researchers will evaluate pain intensity over 24 hours post-extubation, opioid consumption, recovery milestones, and safety outcomes like nausea requiring ondansetron. Patient and surgeon satisfaction are measured using a 5-point Likert scale. Data collection is blinded to minimize bias, and statistical analysis will compare outcomes between groups. The study aims to improve pain management protocols for cardiac surgery patients to support faster recovery and reduce complications.

Comparison of the Efficacy of Combined Transversus Thoracic Plane Block and Serratus Anterior Plane Block Versus Erector Spinae Plane Block in the Management of Sternotomy Pain