Parasternal Block Versus Wound Infiltration for Pain After Median Sternotomy:A Salivary Opiorphin-Based Study

May 30, 2026 updated by: Mehmet Akif Yilmaz, Ataturk University

Determination of the Effect of Parasternal Block Versus Wound Site Infiltration on Postoperative Pain Levels by Salivary Opiorphin Levels in Patients Undergoing Median Sternotomy: A Randomized Prospective Study

This study evaluated the effects of parasternal block and wound site infiltration on postoperative pain in patients undergoing median sternotomy. Patients were allocated to receive parasternal block, wound site infiltration, or standard systemic analgesia. Salivary opiorphin levels and postoperative pain scores were assessed to compare analgesic effectiveness between the groups.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

This randomized prospective study included patients undergoing surgery through median sternotomy. The study compared three perioperative analgesic approaches: parasternal block, wound site infiltration, and standard systemic analgesia without local intervention at the surgical site.

Salivary samples were collected before surgery, after sternotomy, and during the postoperative period to measure opiorphin levels. Postoperative pain was assessed using visual analogue scale scores, and additional analgesic requirement, opioid consumption, extubation time, intensive care unit stay, and adverse effects such as nausea and vomiting were recorded.

Study Type

Interventional

Enrollment (Actual)

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 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 scheduled for surgery through median sternotomy
  • Patients who provided informed consent

Exclusion Criteria:

  • Age under 30 years
  • Presence of ischemic, inflammatory, or systemic disease, except cardiovascular disease
  • Use of analgesic medication within the last 24 hours
  • Diagnosis of psychiatric disorder
  • Presence of any oral pathology, including active dental caries, aphthous lesions, or salivary gland inflammation
  • Prolonged intubation or inability to be separated from mechanical ventilation for more than 8 hours

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: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Double

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Parasternal Block Group
Participants in this group received ultrasound-guided parasternal block with local anesthetic before surgical incision, in addition to standard perioperative systemic analgesia.
Procedure: Parasternal blocks
Ultrasound-guided parasternal block was performed with local anesthetic before surgical incision.
Active Comparator: Wound Site Infiltration Group
Participants in this group received wound site infiltration with local anesthetic before surgical incision, in addition to standard perioperative systemic analgesia.
Procedure: Wound Site Infiltration
Local anesthetic infiltration was performed at the surgical wound site before surgical incision.
No Intervention: Standard Analgesia Group
Participants in this group received standard perioperative systemic analgesia without local anesthetic intervention at the surgical site.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Change in Salivary Opiorphin Level
Time Frame: Baseline, 3 minutes after sternotomy, and postoperative 6 hours
Salivary opiorphin levels were measured using ELISA to evaluate the analgesic effect of the study interventions.
Baseline, 3 minutes after sternotomy, and postoperative 6 hours

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Postoperative Pain Intensity Assessed by the Visual Analogue Scale
Time Frame: At 1, 2, 4, 8, 12, and 24 hours after extubation
Postoperative pain intensity was assessed using the Visual Analogue Scale. The scale ranges from 0 to 10, where 0 indicates no pain and 10 indicates the worst imaginable pain. Higher scores indicate worse postoperative pain.
At 1, 2, 4, 8, 12, and 24 hours after extubation
Additional Analgesic Requirement
Time Frame: Within the first 24 hours after extubation
The need for rescue analgesia was recorded during the postoperative follow-up period.
Within the first 24 hours after extubation
Total Opioid Consumption
Time Frame: Within the first 24 postoperative hours
Total opioid consumption delivered by patient-controlled analgesia was recorded.
Within the first 24 postoperative hours
Extubation Time
Time Frame: Immediately after surgery until tracheal extubation, assessed up to 24 hours postoperatively
Time to extubation was defined as the duration from the end of surgery to tracheal extubation and was recorded in minutes.
Immediately after surgery until tracheal extubation, assessed up to 24 hours postoperatively
Intensive Care Unit Length of Stay
Time Frame: From postoperative intensive care unit admission until intensive care unit discharge, assessed up to 7 days postoperatively
Intensive care unit length of stay was defined as the duration from admission to the intensive care unit after surgery until discharge from the intensive care unit and was recorded in hours.
From postoperative intensive care unit admission until intensive care unit discharge, assessed up to 7 days postoperatively
Postoperative Nausea and Vomiting
Time Frame: Within the first 24 postoperative hours
Postoperative nausea and vomiting were recorded as adverse effects.
Within the first 24 postoperative hours

Collaborators and Investigators

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

Sponsor

Ataturk University

Investigators

  • Study Director: Muhammed Enes Aydin, professor, Ataturk University Department of Anesthesiology and Reanimation

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

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 (Actual)

January 1, 2024

Primary Completion (Actual)

January 1, 2026

Study Completion (Actual)

January 12, 2026

Study Registration Dates

First Submitted

May 21, 2026

First Submitted That Met QC Criteria

May 30, 2026

First Posted (Actual)

June 2, 2026

Study Record Updates

Last Update Posted (Actual)

June 2, 2026

Last Update Submitted That Met QC Criteria

May 30, 2026

Last Verified

May 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • B.30.2.ATA.0.01.00/353
  • 2023/2 (Other Identifier: Atatürk University Clinical Research Ethics Committee)

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

IPD Plan Description

Individual participant data will not be shared due to participant privacy and confidentiality considerations.

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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