Effect of Bilateral Transversus Thoracis Muscle Plane Block in Patients Undergoing Coronary Artery Bypass Graft Surgery. (PARACABS)
Effect of Bilateral Transversus Thoracis Muscle Plane Block on Postoperative Morphine Consumption in Patients Undergoing Elective On-pump Coronary Artery Bypass Graft Surgery: a Retrospective Study.
Coronary artery bypass graft surgery is the standard surgical treatment for coronary disease. However, there is no consensus on analgesic management in patients undergoing CABG.
The aim of the study is to evualuate efficacy of bilateral transversus thoracis muscle plane (TTMP) block combined with systemic analgesia, compared to systemic analgesia only, in patients undergoing elective on-pump CABG surgery.
Our main hypothesis is that a bilateral TTMP block performed after CABG surgery could reduce morphine consumption during the first 48 hours.
The investigators conducted an age, gender and type of surgery-matched retrospective cohort study in the Montpellier University Hospital (France).
調査の概要
研究の種類
入学 (実際)
連絡先と場所
研究場所
-
-
-
Montpellier、フランス、34295
- Uh Montpellier
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参加基準
適格基準
就学可能な年齢
健康ボランティアの受け入れ
受講資格のある性別
サンプリング方法
調査対象母集団
"TTMP Block" group : fifty consecutive patients who underwent elective on-pump coronary artery bypass graft ± valve surgery after October 2019, with a postoperative analgesic protocol including a bilateral TTMP block, associate with systemic analgesia.
"Systemic Analgesia" group : age, gender and type of surgery-matched patients who underwent elective on-pump coronary artery bypass graft ± valve surgery before September 2019, with a postoperative analgesic protocol based on systemic analgesia only.
説明
Inclusion criteria:
- To be over 18
- To be scheduled for CABG surgery in the center of the study during the study period.
Exclusion criteria:
- Chronic pain or opioid use before surgery
- Recent thoracic regional analgesia (< 1 month)
- Preoperative dementia or other neurologic or psychiatric disease incompatible with VAS pain scoring.
- Other technique of regional anesthesia (e.g. thoracic epidural)
- Opposition to data collection
Secondary exlusion criteria:
- Postoperative prolonged sedation in ICU (> 12 hours)
- Postoperative surgical complication requiring surgical revision during the first two days.
- Opposition to data collection expressed secondarily
研究計画
研究はどのように設計されていますか？
デザインの詳細
- 観測モデル：コホート
- 時間の展望：回顧
コホートと介入
グループ/コホート |
介入・治療 |
|---|---|
|
Systemic analgesia
Patients received only systemic analgesia : Acetaminophen, Ketoprofen, and Nefopam were administered systematically.
Morphine was administered if necessary, according to our institutional pain management protocol.
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|
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Bilateral TTMP block + systemic analgesia
Patients received the same protocol of systemic analgesia associated with a bilateral TTMP block performed during the first four hours after ICU admission, before tracheal tube removal.
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In the "TTMP block" group, an ultrasounded guided TTMP block was performed by an anesthesiologist, in ICU, before tracheal tube removal.
Between the 4th et 5th rib, on each side, 40 ml of Ropivacaine 2 mg/ml, in association with Clonidine, was injected "single-shot" in the tranversus thoracis muscle plane.
The targets of local anesthetic were the anterior branches of intercostal nerves from T2 to T6. Dexamethasone 8 mg was injected intravenously.
他の名前：
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この研究は何を測定していますか？
主要な結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
|
cumulative morphine consumption
時間枠：postoperative day 2
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cumulative morphine consumption during the first two days.
cumulative morphine consumption on postoperative day 0, 1 and 2, including the morphine administered in intensive care unit, and on postoperative day 1 and 2.
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postoperative day 2
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二次結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
|
Postoperative pain assessed
時間枠：postoperative day 0, 1 and 2
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Postoperative pain assessed by visual analog scale (VAS) scoring
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postoperative day 0, 1 and 2
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Postoperative nausea and vomiting
時間枠：hospital day 7
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Postoperative nausea and vomiting
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hospital day 7
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Occurrence of prurit
時間枠：postoperative day 7
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Occurrence of prurit
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postoperative day 7
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rate of Delirium
時間枠：postoperative day 7
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rate of Delirium
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postoperative day 7
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rate of Constipation
時間枠：postoperative day 7
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rate of Constipation
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postoperative day 7
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|
rate of Urinary retention
時間枠：until postoperative day 7
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rate of Urinary retention
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until postoperative day 7
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rate of Hypotension
時間枠：until postoperative day 7
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rate of Hypotension
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until postoperative day 7
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Pleural drain duration
時間枠：day 20
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Pleural drain duration
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day 20
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Urinary catheter duration
時間枠：day 20
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Urinary catheter duration
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day 20
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Duration of hospitalization in ICU
時間枠：day 20
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Duration of hospitalization in ICU
|
day 20
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In-hospital length of stay
時間枠：day 20
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In-hospital length of stay
|
day 20
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Occurrence of atrial fibrillation
時間枠：until postoperative day 7
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Occurrence of atrial fibrillation
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until postoperative day 7
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rate of Pneumonia
時間枠：until postoperative day 7
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rate of Pneumonia
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until postoperative day 7
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acute kidney injury
時間枠：until postoperative day 7
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acute kidney injury
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until postoperative day 7
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協力者と研究者
捜査官
- 主任研究者：Pierre Sentenac, MD, PhD、Uh Montpellier
研究記録日
主要日程の研究
研究開始 (実際)
一次修了 (実際)
研究の完了 (実際)
試験登録日
最初に提出
QC基準を満たした最初の提出物
最初の投稿 (実際)
学習記録の更新
投稿された最後の更新 (実際)
QC基準を満たした最後の更新が送信されました
最終確認日
詳しくは
本研究に関する用語
キーワード
その他の研究ID番号
- RECHMPL19_0582
個々の参加者データ (IPD) の計画
個々の参加者データ (IPD) を共有する予定はありますか?
IPD プランの説明
医薬品およびデバイス情報、研究文書
米国FDA規制医薬品の研究
米国FDA規制機器製品の研究
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