Transversus Thoracic Plane Block for Perioperative Analgesia in Cardiac Surgery
Transversus Thoracic Plane Block for Perioperative Analgesia in Cardiac Surgery: a Randomized Controlled Prospective Study
The goal of this clinical trial is to learn if perioperative Transversus Thoracic Plane Block (TTPB) decrease perioperative pain after cardiac surgery. The main questions it aims to answer are:
- does Transversus Thoracic Plane Block decrease perioperative pain after cardiac surgery more than the standard analgesic treatment?
- Are the results different if the investigators perform Transversus Thoracic Plane Block before surgery or at the end of surgery?
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Contact
Study Contact
- Name: Joanna Tohme, MD
- Phone Number: +96170492735
- Email: joanna-tohme@hotmail.com
Study Locations
-
-
-
Beirut, Lebanon, 166830
- Hotel Dieu de France
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
- Adult
- Older Adult
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- All patients scheduled for cardiac surgery via sternotomy under cardiopulmonary bypass
Exclusion Criteria:
- Previous cardiac surgery
- Urgent surgery
- Pregnant women
- Allergy to local anesthetics
- Opioid dependence
- Low ejection fraction < 30%
- Presence or onset of cognitive or neurological disorders preventing pain assessment
- Infection at injection sites
- Coagulopathy
- Patients on dual antiplatelet therapy
- Renal insufficiency with Glomerular filtration rate (GFR) < 30 mL/min
- History of thoracic radiotherapy
- History of mastectomy
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Supportive Care
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Double
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
No Intervention: Placebo
This group receives standard analgesic treatment and no Transversus Thoracic Plane Block is performed
|
|
|
Active Comparator: Transversus Thoracic Plane Block pre
This group receives standard analgesic treatment and Transversus Thoracic Plane Block is performed before surgery
|
The Transversus Thoracic Plane Block is a recent regional anesthesia technique.
It provides analgesia for the anterior cutaneous branches of the intercostal nerves T2-6 to the medial anterior chest wall via a single injection of local anesthesia between the internal intercostal muscle and the transversus thoracic muscle located between the third and fourth (or fourth and fifth) intercostal space.
It is noteworthy that the TTPB can consequently reduce pulmonary morbidity and the need for high-dose opioids.
|
|
Active Comparator: Transversus Thoracic Plane Block post
This group receives standard analgesic treatment and Transversus Thoracic Plane Block is performed at the end of surgery
|
The Transversus Thoracic Plane Block is a recent regional anesthesia technique.
It provides analgesia for the anterior cutaneous branches of the intercostal nerves T2-6 to the medial anterior chest wall via a single injection of local anesthesia between the internal intercostal muscle and the transversus thoracic muscle located between the third and fourth (or fourth and fifth) intercostal space.
It is noteworthy that the TTPB can consequently reduce pulmonary morbidity and the need for high-dose opioids.
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
postoperative pain score
Time Frame: First 24h postoperatively
|
The primary outcome is Postoperative Pain Score: Numeric rating scale (NRS) ratings will be assessed at T1 (= upon patient awakening), T2 (= 12 hours postoperatively), T3 (= 24 hours postoperatively) as well as during various painful moments (coughing, drain removal, mobilization). Numeric rating scale (NRS) is a unidimensional measure of pain intensity. It consists of the patient evaluating his pain out of a series of numbers ranging from 0 to 10, where the 2 respective endpoints are "0 = no pain" and "10 = worst possible pain." |
First 24h postoperatively
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Perioperative opioid requirement
Time Frame: First 24h postoperatively
|
Total dose of opioids required during surgery and 24h postoperatively
|
First 24h postoperatively
|
|
Time to first opioid administration
Time Frame: First 24h postoperatively
|
Time to first opioid administration after surgery
|
First 24h postoperatively
|
|
Time to extubation
Time Frame: First 24h postoperatively
|
Time between arrival to cardiac intensive care unit and extubation
|
First 24h postoperatively
|
|
Patient satisfaction at 24 hours post surgery
Time Frame: First 24h postoperatively
|
Patient satisfaction is measured by asking patients one question at 24 hours post surgery: "On a scale from 0 to 10, 0 = not satisfied at all, 10 = extremely satisfied, how satisfied do you feel concerning pain management during the first 24 hours after surgery? " |
First 24h postoperatively
|
|
Length of stay at cardiac intensive care unit and hospital stay
Time Frame: 3 months postoperatively
|
Length of stay at cardiac intensive care unit and hospital stay
|
3 months postoperatively
|
|
Incidence of postoperative pneumonia and pneumothorax in cardiac intensive care unit
Time Frame: First 24h postoperatively
|
Incidence of postoperative pneumonia and pneumothorax in cardiac intensive care unit
|
First 24h postoperatively
|
Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Study Director: Samia Madi Jebara, MD,PHD, Saint-Joseph University
Publications and helpful links
General Publications
- Fujii S, Bairagi R, Roche M, Zhou JR. Transversus Thoracis Muscle Plane Block. Biomed Res Int. 2019 Jul 7;2019:1716365. doi: 10.1155/2019/1716365. eCollection 2019.
- Wong HMK, Chen PY, Tang GCC, Chiu SLC, Mok LYH, Au SSW, Wong RHL. Deep Parasternal Intercostal Plane Block for Intraoperative Pain Control in Cardiac Surgical Patients for Sternotomy: A Prospective Randomized Controlled Trial. J Cardiothorac Vasc Anesth. 2024 Mar;38(3):683-690. doi: 10.1053/j.jvca.2023.11.038. Epub 2023 Nov 30.
- Jeanneteau A, Demarquette A, Blanchard-Daguet A, Fouquet O, Lasocki S, Riou J, Rineau E, Leger M. Effect of superficial and deep parasternal blocks on recovery after cardiac surgery: study protocol for a randomized controlled trial. Trials. 2023 Jul 6;24(1):444. doi: 10.1186/s13063-023-07446-2.
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- CEHDF2392
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.