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

Not yet recruiting

Conditions

Intervention / Treatment

Study Type

Interventional

Enrollment (Estimated)

120

Phase

  • 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 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

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
Intervention / Treatment
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

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

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

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)

June 15, 2026

Primary Completion (Estimated)

April 1, 2027

Study Completion (Estimated)

July 31, 2027

Study Registration Dates

First Submitted

May 14, 2026

First Submitted That Met QC Criteria

May 14, 2026

First Posted (Actual)

May 20, 2026

Study Record Updates

Last Update Posted (Actual)

May 20, 2026

Last Update Submitted That Met QC Criteria

May 14, 2026

Last Verified

May 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID 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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