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July 11, 2022Cardiovascular journal of South Africa/Cardiovascular journal of Southern AfricaOpen Access

Evaluation of the effect of different block techniques on open-heart surgery in the postoperative period: a prospective observational study

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Key result

Parasternal block provided longer block duration and significantly lower postoperative pain scores at rest at the fourth hour (VAS 1.38 vs 4.08) compared to the PECS II block in patients undergoing open-heart surgery.

Why the study?

Open-heart surgery causes severe postoperative pain, and regional anaesthesia techniques represent a promising strategy to achieve adequate analgesia and improve early recovery.

Does parasternal block improve postoperative analgesia compared to PECS II block in patients undergoing open-heart surgery with sternotomy?

Population

100 ASA I-III patients aged 18 years and over undergoing open-heart surgery with sternotomy

Comparison

PECS II block vs parasternal (PS) block

Design

Prospective observational study

Authors

STSeray TürkmenMMMehmet Mutlu

Discussion

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Overview

Regional anesthesia may aid early recovery after open-heart surgery; leaves open need for RCTs to confirm efficacy.

Study Design

Type

Observational (n=100)

Multicenter

No

Structured PICO

Does parasternal block improve postoperative analgesia compared to PECS II block in patients undergoing open-heart surgery with sternotomy?

P
Population
100 adult patients (ASA I-III) undergoing open-heart surgery with sternotomy for coronary artery bypass grafting or valve replacement, followed for 24 hours postoperatively.
I
Intervention
Pectoral nerve (PECS II) block with 20 ml 0.25% bupivacaine injected into each site under ultrasound guidance (n=50).
C
Comparator
Parasternal (PS) block with 2 ml of 0.25% bupivacaine injected into each parasternal space (total 10 injections) under ultrasound guidance (n=50).
O
Outcome
Pain scores at rest after extubation (assessed with visual analogue scale).patient reported

Main Result

Absolute Event Rate: 4.08% vs 1.38%

p-value: p=0.001

Parasternal block provides superior postoperative analgesia, longer block duration, and reduced opioid consumption compared to PECS II block after open-heart surgery with sternotomy.

Limitations

  • Length of stay in the intensive care unit was not determined.
  • Did not determine the length of stay in the intensive care unit

Cite This Study

Türkmen et al. (2022) conducted an observational in Open-heart surgery (n=100). Pectoral nerve (PECS II) block vs. Parasternal (PS) block was evaluated on Pain scores at rest after extubation (VAS) at 4th hour (p=0.001). Parasternal block provided longer block duration and significantly lower postoperative pain scores at rest at the fourth hour (VAS 1.38 vs 4.08) compared to the PECS II block in patients undergoing open-heart surgery.

synapsesocial.com/papers/6a78c31898f24dbf64bddebfhttps://doi.org/10.5830/cvja-2022-016
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Also Consider

Synapse has enriched 3 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Parasternal Block and Local Anesthetic Infiltration with Levobupivacaine After Cardiac Surgery with Desflurane: The Effect on Postoperative Pain, Pulmonary Function, and Tracheal Extubation Times2004 · 147 citations
  2. 2Regional anesthesia for cardiac surgery2019 · 65 citations
  3. 3Efficacy of erector spinae plane block for analgesia in breast surgery: a systematic review and meta‐analysis2020 · 184 citations