- ICH GCP
- US Clinical Trials Registry
- Klinisk forsøg NCT07692659
Ultrasound-Guided Parasternal/Rectus Sheath Block vs Erector Spinae Plane Block for Pain Control in Cardiac Surgery
Comparison of Ultrasound Guided Bilateral Parasternal Block With Bilateral Rectus Sheath Block Versus Ultrasound Guided Bilateral Erector Spinae Plane Block in Controlling Intra and Post-operative Pain After Cardiac Surgeries
Studieoversigt
Status
Betingelser
Intervention / Behandling
Detaljeret beskrivelse
Optimal anesthesia in cardiac surgery requires careful management to avoid sympathetic stimulation, with analgesia being central to patient safety and recovery. Traditionally, high-dose opioids were used, but this approach delays extubation, conflicting with fast-track protocols that emphasize early extubation. Consequently, opioid-free analgesia has gained importance, employing regional techniques such as neuraxial, paravertebral, and fascial plane blocks.
Thoracic epidural analgesia (TEA) offers effective pain control and reduces perioperative cardiovascular and respiratory complications. However, its use in anticoagulated patients raises concern for epidural hematoma. Alternatives like paravertebral and fascial plane blocks provide comparable analgesia with lower risk. The erector spinae plane block (ESPB) reduces analgesic requirements, though deep blocks still pose bleeding risks.
Superficial plane blocks are therefore clinically valuable. The parasternal intercostal block-targeting anterior cutaneous branches of intercostal nerves-has emerged as a safe option for patients undergoing median sternotomy while on anticoagulant or antiplatelet therapy. Additionally, bilateral rectus sheath block can reduce chest tube insertion pain after cardiac surgery.
Undersøgelsestype
Tilmelding (Anslået)
Fase
- Ikke anvendelig
Kontakter og lokationer
Studiekontakt
- Navn: Walaa Y Elsabeeny, MD
- Telefonnummer: 01007798466
- E-mail: walaa.elsabeeny@nci.cu.edu.eg
Undersøgelse Kontakt Backup
- Navn: Mostafa A Ibrahim, MD
- Telefonnummer: +966541227090
- E-mail: MAbIbrahim@sghgroup.net
Deltagelseskriterier
Berettigelseskriterier
Aldre berettiget til at studere
- Voksen
- Ældre voksen
Tager imod sunde frivillige
Beskrivelse
Inclusion Criteria:
- Both sexes,
- ASA III-IV patients
- body mass index between 20- 35 kg/m2
- adult patients above 18 years old will be included in the study
Exclusion Criteria:
- Patients with global hypokinesia
- ejection fraction < 40%
- low platelet count
- coagulation impairment
- deformity in the vertebral column
- severe renal and hepatic impairment
- any known allergy to the drugs used
Studieplan
Hvordan er undersøgelsen tilrettelagt?
Design detaljer
- Primært formål: Behandling
- Tildeling: Randomiseret
- Interventionel model: Parallel tildeling
- Maskning: Dobbelt
Våben og indgreb
Deltagergruppe / Arm |
Intervention / Behandling |
|---|---|
|
Eksperimentel: Parasternal/ Rectus sheath
Patients will receive Parasternal and rectus sheath blocks; with injection of 10 ml bupivacaine 0.25% in each side after confirmation of needle position.
Both parasternal and rectus heath blocks will be performed bilaterally
|
the parasternal block will be performed parasternally at the level of fifth rib to the plane between the pectoralis major and the internal intercostal muscle.
The rectus sheath block will be performed through injection in the plane posterior to the rectus abdominis muscle and anterior to the posterior rectus sheath
|
|
Eksperimentel: Erector Spinae Plane Block
The patients will receive a bilateral ESPB with an injection of 20 ml of bupivacaine 0.25%.
|
injection above the transverse process
|
Hvad måler undersøgelsen?
Primære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
|
Numeric rating score
Tidsramme: 24 hours
|
postoperative pain scores using Numerical Rating Scale (NRS)
|
24 hours
|
Sekundære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
|
postoperative opioid consumption
Tidsramme: 24 hours
|
opioid consumption in the first 24 hours postoperatively
|
24 hours
|
|
extubation time
Tidsramme: immediate postoperative
|
time to extubate
|
immediate postoperative
|
|
first time to request analgesia
Tidsramme: 24 hours
|
first time to request opioid analgesia
|
24 hours
|
|
peri-operative hemodynamics
Tidsramme: intraoperative and 24 hours
|
incidence of hypotension, hypertension, tachycardia and bradycardia
|
intraoperative and 24 hours
|
Samarbejdspartnere og efterforskere
Sponsor
Samarbejdspartnere
Efterforskere
- Ledende efterforsker: Walaa Y Elsabeeny, MD, A Professor of Anesthesia, Critical Care and Pain Management, National Cancer Institute, Cairo University
Datoer for undersøgelser
Studer store datoer
Studiestart (Anslået)
Primær færdiggørelse (Anslået)
Studieafslutning (Anslået)
Datoer for studieregistrering
Først indsendt
Først indsendt, der opfyldte QC-kriterier
Først opslået (Faktiske)
Opdateringer af undersøgelsesjournaler
Sidste opdatering sendt (Faktiske)
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidst verificeret
Mere information
Begreber relateret til denne undersøgelse
Yderligere relevante MeSH-vilkår
Andre undersøgelses-id-numre
- ECC-2025-64
Lægemiddel- og udstyrsoplysninger, undersøgelsesdokumenter
Studerer et amerikansk FDA-reguleret lægemiddelprodukt
Studerer et amerikansk FDA-reguleret enhedsprodukt
Disse oplysninger blev hentet direkte fra webstedet clinicaltrials.gov uden ændringer. Hvis du har nogen anmodninger om at ændre, fjerne eller opdatere dine undersøgelsesoplysninger, bedes du kontakte register@clinicaltrials.gov. Så snart en ændring er implementeret på clinicaltrials.gov, vil denne også blive opdateret automatisk på vores hjemmeside .
Kliniske forsøg med Perioperativ analgesi
-
Cukurova UniversityScientific Research Projects Coordination UnitAktiv, ikke rekrutterendeSygepleje | Intensiv pleje | Neurokirurgisk kirurgi | Sedo-AnalgesiaTyrkiet (Türkiye)
-
Karolinska InstitutetRekrutteringGenerel Kirurgi | Perioperativ medicin | Fysisk inaktivitet | Perioperativ komplikationSverige
-
Ain Shams UniversityRekrutteringPerioperativ analgesiEgypten
-
Istinye UniversityIkke rekrutterer endnuPerioperativ diafragmeforskydningTyrkiet (Türkiye)
-
Medical University of ViennaRekruttering
-
Second Affiliated Hospital, School of Medicine,...RekrutteringPerioperativ periodeKina
-
University Hospital, Basel, SwitzerlandRekrutteringPerioperativ patientsikkerhedSchweiz, Holland
-
Hospital Samaritano PaulistaIkke rekrutterer endnu
-
Fondazione Policlinico Universitario Agostino Gemelli...RekrutteringDødelighed og komplikationer i endovaskulære procedurer udført med ny generation af lavprofilenhederPerioperativ dødelighedItalien
-
Karolinska InstitutetAfsluttet
Kliniske forsøg med Parasternal/ Rectus sheath block
-
Abd-Elazeem Abd-Elhameed ElbakryAktiv, ikke rekrutterende
-
Damanhour Teaching HospitalRekrutteringPostoperative smerterEgypten
-
Hitit UniversityAfsluttet
-
Konya City HospitalAfsluttet
-
Eulji University HospitalRekrutteringPostoperativ smerte | Laparoskopisk kolecystektomiSydkorea
-
Patel Hospital, PakistanTilmelding efter invitation
-
Countess of Chester NHS Foundation TrustUkendtSmerter, postoperativ | Indsnit | Sår; Mave
-
Cumhuriyet UniversityIkke rekrutterer endnu
-
Vancouver Coastal HealthUniversity of British Columbia; Vancouver Prostate CentreUkendtPostoperativ smerte | BlærekræftCanada
-
Qilu Hospital of Shandong UniversityRekrutteringRektale neoplasmer | Ileostomi - StomiKina