Efficacy of Multiple Nerve Blocks on the Recovery of Patients Undergoing Off Pump CABG Surgeries

August 27, 2026 updated by: Ain Shams University

Enhancement of the Recovery Profile in Patients Undergoing Off-Pump Coronary Artery Bypass Graft Surgery Through Combination of Multiple Regional Nerve Blocks

In cardiac surgery patients , effective pain control is crucial to support early extubation, mobilization, and cognitive recovery, yet systemic opioids carry substantial risks such as respiratory depression, delirium, and delayed rehabilitation. While regional fascial plane blocks offer a safer, opioid-sparing alternative, no single technique provides complete analgesia for the complex and multi-dermatomal pain generated by sternotomy, graft harvesting, chest wall retraction, and drain sites. Therefore, a multimodal approach combining blocks such as parasternal nerve block , rectus sheath nerve block and femoral nerve block , may cover most of areas expected to be sources of intraoperative and post-operative pain in cardiac surgery patients.

Study Overview

Status

Recruiting

Conditions

Intervention / Treatment

Study Type

Interventional

Enrollment (Estimated)

30

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

  • Egypt
      • Cairo, Egypt
        • Recruiting
        • Ain shams university hospitals

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:

  • o Scheduled for elective off-pump coronary artery bypass graft (OPCAB) surgery via median sternotomy

    • American Society of Anesthesiologists (ASA) physical status III - IV
    • Ability to provide informed consent

Exclusion Criteria:

  • o Emergency or redo cardiac surgery

    • On-pump CABG or concomitant valve or aortic procedures
    • Known allergy to local anesthetics or study drugs
    • Coagulopathy or ongoing anticoagulant therapy contraindicating regional block
    • Preoperative chronic opioid use or opioid dependency
    • Neurologic or psychiatric conditions interfering with pain assessment
    • Infection at the block injection site
    • Severe hepatic or renal impairment
    • Body mass index (BMI) > 40 kg/m²
    • Inability to understand or cooperate with pain scoring or postoperative care.

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: Quadruple

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Active Comparator: Group A (intervention)
Patients in this group will receive standardized general anaesthesia with a preemptive bilateral superficial parasternal nerve block using 20 mL of 0.25% bupivacaine per side, in combination with a rectus sheath block (RSB) using 10 mL of 0.25% bupivacaine per side. and femoral nerve block at the side of harvesting using 10 mL of 0.25% bupivacaine.
Procedure: regional nerve block with local anesthesia
Patients will receive bilateral superficial parasternal nerve block using 20 mL of 0.25% bupivacaine per side, in combination with a rectus sheath block (RSB) using 10 mL of 0.25% bupivacaine per side. and femoral nerve block at the side of harvesting using 10 mL of 0.25% bupivacaine.
Placebo Comparator: Group B ( control)
Patients will receive standardized general anesthesia with placebo (saline) injections administered in the same anatomical planes.
Procedure: Placebo
Patients will receive placebo (saline) injections administered in the same anatomical planes.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Time to Extubation
Time Frame: from transferal to ICU until successful tracheal extubation assessed during post operative ICU stay up to 48 hours
Defined as the interval (in hours) from transferal to ICU to successful tracheal extubation
from transferal to ICU until successful tracheal extubation assessed during post operative ICU stay up to 48 hours

Collaborators and Investigators

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

Sponsor

Ain Shams University

Investigators

  • Study Director: Sherif S Sultan, MD, Faculty of medicine ain shams 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)

September 10, 2026

Primary Completion (Estimated)

March 31, 2027

Study Completion (Estimated)

April 7, 2027

Study Registration Dates

First Submitted

April 2, 2026

First Submitted That Met QC Criteria

August 27, 2026

First Posted (Actual)

August 31, 2026

Study Record Updates

Last Update Posted (Actual)

August 31, 2026

Last Update Submitted That Met QC Criteria

August 27, 2026

Last Verified

April 1, 2026

More Information

Terms related to this study

Additional Relevant MeSH Terms

Other Study ID Numbers

  • FMASU MD362/2025

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

UNDECIDED

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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