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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).
Studie Overzicht
Toestand
Conditie
Interventie / Behandeling
Studietype
Inschrijving (Werkelijk)
Contacten en locaties
Studie Locaties
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Montpellier, Frankrijk, 34295
- Uh Montpellier
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Deelname Criteria
Geschiktheidscriteria
Leeftijden die in aanmerking komen voor studie
Accepteert gezonde vrijwilligers
Geslachten die in aanmerking komen voor studie
Bemonsteringsmethode
Studie Bevolking
"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.
Beschrijving
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
Studie plan
Hoe is de studie opgezet?
Ontwerpdetails
- Observatiemodellen: Cohort
- Tijdsperspectieven: Retrospectief
Cohorten en interventies
Groep / Cohort |
Interventie / Behandeling |
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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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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.
Andere namen:
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Wat meet het onderzoek?
Primaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
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cumulative morphine consumption
Tijdsspanne: 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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Secundaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
|---|---|---|
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Postoperative pain assessed
Tijdsspanne: 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
Tijdsspanne: 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
Tijdsspanne: postoperative day 7
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Occurrence of prurit
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postoperative day 7
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rate of Delirium
Tijdsspanne: postoperative day 7
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rate of Delirium
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postoperative day 7
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rate of Constipation
Tijdsspanne: 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
Tijdsspanne: 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
Tijdsspanne: 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
Tijdsspanne: day 20
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Pleural drain duration
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day 20
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Urinary catheter duration
Tijdsspanne: day 20
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Urinary catheter duration
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day 20
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Duration of hospitalization in ICU
Tijdsspanne: day 20
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Duration of hospitalization in ICU
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day 20
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In-hospital length of stay
Tijdsspanne: day 20
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In-hospital length of stay
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day 20
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Occurrence of atrial fibrillation
Tijdsspanne: 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
Tijdsspanne: 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
Tijdsspanne: until postoperative day 7
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acute kidney injury
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until postoperative day 7
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Medewerkers en onderzoekers
Sponsor
Onderzoekers
- Hoofdonderzoeker: Pierre Sentenac, MD, PhD, Uh Montpellier
Studie record data
Bestudeer belangrijke data
Studie start (Werkelijk)
Primaire voltooiing (Werkelijk)
Studie voltooiing (Werkelijk)
Studieregistratiedata
Eerst ingediend
Eerst ingediend dat voldeed aan de QC-criteria
Eerst geplaatst (Werkelijk)
Updates van studierecords
Laatste update geplaatst (Werkelijk)
Laatste update ingediend die voldeed aan QC-criteria
Laatst geverifieerd
Meer informatie
Termen gerelateerd aan deze studie
Trefwoorden
Aanvullende relevante MeSH-voorwaarden
Andere studie-ID-nummers
- RECHMPL19_0582
Plan Individuele Deelnemersgegevens (IPD)
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