Analgesic Efficacy of Erector Spinae Plane Block Versus Combined Pecto-intercostal and Recto-intercostal Fascial Plane Block in Patients Undergoing Cardiac Surgery: A Randomized Comparative Trial

What this Trial Is About

Researchers are studying the pain relief effects of two different ultrasound-guided nerve block techniques in patients undergoing cardiac surgery involving a sternotomy. The study aims to compare the erector spinae plane block with a combination of pecto-intercostal fascial plane block and recto-intercostal fascial plane block to see which provides better postoperative pain control. This research addresses the high incidence of severe acute pain after median sternotomy and seeks to improve analgesic options for such patients. The study involves two groups: one receiving the erector spinae plane block with 20 ml of 0.25% bupivacaine injected on each side near the fourth thoracic vertebra, and the other receiving combined pecto-intercostal and recto-intercostal fascial plane blocks with 10-15 ml of 0.25% bupivacaine injected at specified chest locations on each side. Both procedures are guided by ultrasound and doses are carefully controlled to stay within safe limits. The blocks are performed during cardiac surgery that uses cardiopulmonary bypass and midline sternotomy. Participants will be monitored for total opioid use in the first 24 hours after surgery, pain scores at multiple time points up to 48 hours, intraoperative fentanyl dosage, extubation time, side effects, and incidence of chronic pain at 3 and 6 months. The study includes double-blind randomization to either treatment group. Safety and analgesic effectiveness will be closely assessed during and after surgery, with follow-up extending to 6 months to evaluate long-term pain outcomes.

Erector Spinae Block Versus Combined Pecto-intercostal and Recto-intercostal Fascial Plane Block in Cardiac Surgery