Comparing Dexmedetomidine Plus Ropivacaine to Ropivacaine Alone for Bilateral Pectoralis Nerve Blocks in Open Heart Surgery Patients

What this Trial Is About

Researchers are evaluating the use of dexmedetomidine added to ropivacaine in bilateral Pectoral nerve PECS block to improve anesthesia duration and postoperative pain relief for patients undergoing cardiac surgery through midline sternotomy. This phase 4, double-blind randomized controlled study aims to compare the effects of this combination with plain ropivacaine and a control group receiving only fentanyl. The PECS block is a less invasive regional analgesic technique that has been successfully applied in various chest wall surgeries. The study involves three groups of 30 patients each one group receives bilateral PECS block with 30 ml of 0.25% ropivacaine plus dexmedetomidine 0.5 mcgkg per side the second group receives 30 ml of 0.25% plain ropivacaine per side and the control group receives no regional anesthesia but continuous intravenous fentanyl at 1 mcgkghr. All patients receive standard anesthesia, including total intravenous anesthesia with fentanyl, midazolam, and rocuronium, followed by paracetamol infusion after surgery. The PECS block is guided by ultrasound and performed in a supine position, with local anesthetic injected between specific muscle layers. Participants will be monitored through pain assessments using the Visual Analog Scale at multiple intervals during the first 24 hours after extubation, duration of mechanical ventilation, total fentanyl consumption, incidence of complications, length of ICU stay, and patient satisfaction measured by a five-item Likert scale. The study includes assessments of hemodynamic stability, blood gases, coagulation time, and drain output before performing the block. The trial will continue until January 2025, with close monitoring post-surgery in the surgical ICU until patients are fully awake and extubated.

Dexmedetomidine Ropivacaine Versus Plain Ropivacaine in Bilateral Pectoralis Nerve (PECS) Block