Parasternal and Adductor Canal Blocks in CABG

May 14, 2026 updated by: Merve Sena BAYTAR, Zonguldak Bulent Ecevit University

Comparison of Postoperative Analgesic Efficacy of Parasternal Block and Parasternal Block Combined With Adductor Canal Block in Coronary Artery Bypass Graft Surgery: A Randomized Controlled Trial

This randomized controlled trial evaluates the effectiveness of different postoperative analgesic strategies in patients undergoing coronary artery bypass graft (CABG) surgery. Patients were allocated into three groups receiving either conventional analgesia alone, parasternal block in addition to conventional analgesia, or combined parasternal and adductor canal blocks with conventional analgesia. The study aims to compare postoperative pain scores, opioid consumption, and recovery outcomes among the groups in order to determine whether the addition of regional anesthesia techniques, particularly the combined block approach, provides superior analgesia and enhances postoperative recovery following CABG surgery.

Study Overview

Status

Status

Indicates the current recruitment status or the expanded access status.
Not yet recruiting

Conditions

Conditions

The disease, disorder, syndrome, illness, or injury that is being studied. On ClinicalTrials.gov, conditions may also include other health-related issues, such as lifespan, quality of life, and health risks.

Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.

Study Type

Study Type

Describes the nature of a clinical study. Study types include interventional studies (also called clinical trials), observational studies (including patient registries), and expanded access.
Interventional

Enrollment (Estimated)

Enrollment

The number of participants in a clinical study. The "anticipated" enrollment is the target number of participants that the researchers need for the study.
120

Phase

Phase

The stage of a clinical trial studying a drug or biological product, based on definitions developed by the U.S. Food and Drug Administration (FDA). The phase is based on the study's objective, the number of participants, and other characteristics. There are five phases: Early Phase 1 (formerly listed as Phase 0), Phase 1, Phase 2, Phase 3, and Phase 4. Not Applicable is used to describe trials without FDA-defined phases, including trials of devices or behavioral interventions.
  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Contact

The name and contact information for the person who can answer enrollment questions for a clinical study. Each location where the study is being conducted may also have a specific contact, who may be better able to answer those questions.

Study Locations

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Eligibility Criteria

The key requirements that people who want to participate in a clinical study must meet or the characteristics they must have. Eligibility criteria consist of both inclusion criteria (which are required for a person to participate in the study) and exclusion criteria (which prevent a person from participating). Types of eligibility criteria include whether a study accepts healthy volunteers, has age or age group requirements, or is limited by sex.

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  • Patients aged 18-80 years Patients classified as American Society of Anesthesiologists (ASA) physical status II-IV Patients scheduled for elective coronary artery bypass graft (CABG) surgery under general anesthesia Patients undergoing saphenous vein graft harvesting during CABG surgery Patients able to understand and use the Numeric Rating Scale (NRS) and Quality of Recovery-15 (QoR-15) questionnaire Patients who provided written informed consent to participate in the study

Exclusion Criteria:

  • Patient refusal to participate in the study Known allergy or hypersensitivity to local anesthetics, morphine, or study-related medications Emergency coronary artery bypass graft surgery History of chronic opioid use or opioid dependence Pre-existing chronic pain syndromes requiring regular analgesic treatment Cognitive impairment or inability to understand the Numeric Rating Scale (NRS) or Quality of Recovery-15 (QoR-15) questionnaire Coagulopathy or ongoing anticoagulant therapy contraindicating regional anesthesia techniques Local infection at the planned block sites Severe hepatic or renal dysfunction Previous surgery or anatomical abnormality preventing performance of the regional blocks Conversion to a surgical procedure other than planned CABG during the intraoperative period Hemodynamic instability requiring mechanical circulatory support or reoperation in the early postoperative period Patients requiring prolonged postoperative mechanical ventilation or deep sedation preventing postoperative pain assessment

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Prevention
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Double

Arms and Interventions

Participant Group / Arm

Participant Group / Arm

A group or subgroup of participants in a clinical trial that receives a specific intervention/treatment, or no intervention, according to the trial's protocol.
Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.
Active Comparator: Conventional analgesia
Other: conventional analgesic regimen
Patients received standard postoperative analgesia consisting of intravenous patient-controlled analgesia (PCA) with morphine following coronary artery bypass graft surgery. The PCA device was initiated in the postoperative period according to institutional analgesia protocols, allowing patient-administered morphine dosing for pain control. Additional rescue analgesics were administered when clinically indicated.
Active Comparator: Parasternal block
Procedure: parasternal block
Ultrasound-guided parasternal block was performed bilaterally after induction of general anesthesia in patients undergoing coronary artery bypass graft surgery. Following aseptic skin preparation, a high-frequency linear ultrasound probe was placed parallel to the sternum to identify the parasternal intercostal plane. A block needle was advanced under ultrasound guidance, and local anesthetic was injected into the interfascial plane adjacent to the sternum to provide anterior thoracic wall analgesia. The procedure was performed according to institutional standardized block protocols.
Active Comparator: Parasternal block + Adductor canal block
Procedure: Parasternal block + Adductor canal block
In addition to conventional analgesia, patients received ultrasound-guided bilateral parasternal block and adductor canal block after induction of general anesthesia. The parasternal block was performed by injecting local anesthetic into the interfascial plane adjacent to the sternum under ultrasound guidance to provide anterior thoracic wall analgesia. The adductor canal block was performed under ultrasound guidance by depositing local anesthetic within the adductor canal to provide analgesia at the saphenous vein graft harvesting site. All procedures were performed according to standardized institutional protocols.

What is the study measuring?

Primary Outcome Measures

Primary Outcome Measures

In a clinical study's protocol, the planned outcome measure that is the most important for evaluating the effect of an intervention/treatment. Most clinical studies have one primary outcome measure, but some have more than one.
Outcome Measure
Measure Description
Time Frame
Postoperative opioid consumption
Time Frame: At postoperative 0,1, 2, 4, 8, 12, 24, 48, and 72 hours; total morphine consumption at 72 hours
Postoperative opioid consumption will be assessed as the cumulative morphine dose administered via intravenous patient-controlled analgesia (PCA). Morphine consumption will be recorded at predefined postoperative time points, and total morphine consumption will be calculated at 72 hours after surgery.
At postoperative 0,1, 2, 4, 8, 12, 24, 48, and 72 hours; total morphine consumption at 72 hours

Secondary Outcome Measures

Secondary Outcome Measures

In a clinical study's protocol, a planned outcome measure that is not as important as the primary outcome measure for evaluating the effect of an intervention but is still of interest. Most clinical studies have more than one secondary outcome measure.
Outcome Measure
Measure Description
Time Frame
Postoperative pain scores assessed using the Numeric Rating Scale (NRS)
Time Frame: At postoperative 0, 1, 2, 4, 8, 12, 24, 48, and 72 hours
Postoperative pain intensity will be evaluated using the Numeric Rating Scale (NRS), where 0 indicates no pain and 10 indicates the worst imaginable pain. Pain scores will be recorded at predefined postoperative time points up to 72 hours after surgery.
At postoperative 0, 1, 2, 4, 8, 12, 24, 48, and 72 hours
Quality of Recovery-15 (QoR-15) score
Time Frame: At postoperative 24 and 72 hours
Postoperative recovery quality will be assessed using the Quality of Recovery-15 (QoR-15) questionnaire at 24 and 72 hours after surgery. The QoR-15 is a validated patient-reported outcome measure evaluating multiple domains of postoperative recovery, with higher scores indicating better recovery quality.
At postoperative 24 and 72 hours
Postoperative nausea and vomiting and antiemetic consumption
Time Frame: At postoperative 0, 1, 2, 4, 8, 12, 24, 48, and 72 hours
Postoperative nausea and vomiting (PONV) will be evaluated at predefined postoperative time points using a standardized nausea-vomiting scoring system. The requirement for rescue antiemetic treatment and the total amount of antiemetic medication administered during the first 72 postoperative hours will also be recorded.
At postoperative 0, 1, 2, 4, 8, 12, 24, 48, and 72 hours

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Sponsor

The organization or person who initiates the study and who has authority and control over the study.
Zonguldak Bulent Ecevit University

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Estimated)

Study Start

The actual date on which the first participant was enrolled in a clinical study. The "anticipated" study start date is the date that the researchers think will be the study start date.
June 15, 2026

Primary Completion (Estimated)

Primary Completion

The date on which the last participant in a clinical study was examined or received an intervention to collect final data for the primary outcome measure. Whether the clinical study ended according to the protocol or was terminated does not affect this date. For clinical studies with more than one primary outcome measure with different completion dates, this term refers to the date on which data collection is completed for all the primary outcome measures. The "anticipated" primary completion date is the date that the researchers think will be the primary completion date for the study.
April 1, 2027

Study Completion (Estimated)

Study Completion

The date on which the last participant in a clinical study was examined or received an intervention/treatment to collect final data for the primary outcome measures, secondary outcome measures, and adverse events (that is, the last participant's last visit). The "anticipated" study completion date is the date that the researchers think will be the study completion date.
July 31, 2027

Study Registration Dates

First Submitted

First Submitted

The date on which the study sponsor or investigator first submitted a study record to ClinicalTrials.gov. There is typically a delay of a few days between the first submitted date and the record's availability on ClinicalTrials.gov (the first posted date).
May 14, 2026

First Submitted That Met QC Criteria

First Submitted That Met QC Criteria

The date on which the study sponsor or investigator first submits a study record that is consistent with National Library of Medicine (NLM) quality control (QC) review criteria. The sponsor or investigator may need to revise and submit a study record one or more times before NLM's QC review criteria are met. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
May 14, 2026

First Posted (Actual)

First Posted

The date on which the study record was first available on ClinicalTrials.gov after National Library of Medicine (NLM) quality control (QC) review has concluded. There is typically a delay of a few days between the date the study sponsor or investigator submitted the study record and the first posted date.
May 20, 2026

Study Record Updates

Last Update Posted (Actual)

Last Update Posted

The most recent date on which changes to a study record were made available on ClinicalTrials.gov. There may be a delay between when the changes were submitted to ClinicalTrials.gov by the study's sponsor or investigator (the last update submitted date) and the last update posted date.
May 20, 2026

Last Update Submitted That Met QC Criteria

Last Update Submitted That Met QC Criteria

The most recent date on which the study sponsor or investigator submitted changes to a study record that are consistent with National Library of Medicine (NLM) quality control (QC) review criteria. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
May 14, 2026

Last Verified

Last Verified

The most recent date on which the study sponsor or investigator confirmed the information about a clinical study on ClinicalTrials.gov as accurate and current. If a study with a recruitment status of recruiting; not yet recruiting; or active, not recruiting has not been confirmed within the past 2 years, the study's recruitment status is shown as unknown.
May 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

Other Study ID Numbers

Identifiers or ID numbers other than the NCT number that are assigned to a clinical study by the study's sponsor, funders, or others. These numbers may include unique identifiers from other trial registries and National Institutes of Health grant numbers.
  • AEŞH-EK-2026-053

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

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.

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