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Parasternal and Adductor Canal Blocks in CABG

14 maj 2026 uppdaterad av: Merve Sena BAYTAR, Zonguldak Bulent Ecevit University

Comparison of Postoperative Analgesic Efficacy of Parasternal Block and Parasternal Block Combined With Adductor Canal Block in Coronary Artery Bypass Graft Surgery: A Randomized Controlled Trial

This randomized controlled trial evaluates the effectiveness of different postoperative analgesic strategies in patients undergoing coronary artery bypass graft (CABG) surgery. Patients were allocated into three groups receiving either conventional analgesia alone, parasternal block in addition to conventional analgesia, or combined parasternal and adductor canal blocks with conventional analgesia. The study aims to compare postoperative pain scores, opioid consumption, and recovery outcomes among the groups in order to determine whether the addition of regional anesthesia techniques, particularly the combined block approach, provides superior analgesia and enhances postoperative recovery following CABG surgery.

Studieöversikt

Status

Har inte rekryterat ännu

Betingelser

Intervention / Behandling

Studietyp

Interventionell

Inskrivning (Beräknad)

120

Fas

  • Inte tillämpbar

Kontakter och platser

Det här avsnittet innehåller kontaktuppgifter för dem som genomför studien och information om var denna studie genomförs.

Studiekontakt

Studieorter

Deltagandekriterier

Forskare letar efter personer som passar en viss beskrivning, så kallade behörighetskriterier. Några exempel på dessa kriterier är en persons allmänna hälsotillstånd eller tidigare behandlingar.

Urvalskriterier

Åldrar som är berättigade till studier

  • Vuxen
  • Äldre vuxen

Tar emot friska volontärer

Nej

Beskrivning

Inclusion Criteria:

  • Patients aged 18-80 years Patients classified as American Society of Anesthesiologists (ASA) physical status II-IV Patients scheduled for elective coronary artery bypass graft (CABG) surgery under general anesthesia Patients undergoing saphenous vein graft harvesting during CABG surgery Patients able to understand and use the Numeric Rating Scale (NRS) and Quality of Recovery-15 (QoR-15) questionnaire Patients who provided written informed consent to participate in the study

Exclusion Criteria:

  • Patient refusal to participate in the study Known allergy or hypersensitivity to local anesthetics, morphine, or study-related medications Emergency coronary artery bypass graft surgery History of chronic opioid use or opioid dependence Pre-existing chronic pain syndromes requiring regular analgesic treatment Cognitive impairment or inability to understand the Numeric Rating Scale (NRS) or Quality of Recovery-15 (QoR-15) questionnaire Coagulopathy or ongoing anticoagulant therapy contraindicating regional anesthesia techniques Local infection at the planned block sites Severe hepatic or renal dysfunction Previous surgery or anatomical abnormality preventing performance of the regional blocks Conversion to a surgical procedure other than planned CABG during the intraoperative period Hemodynamic instability requiring mechanical circulatory support or reoperation in the early postoperative period Patients requiring prolonged postoperative mechanical ventilation or deep sedation preventing postoperative pain assessment

Studieplan

Det här avsnittet ger detaljer om studieplanen, inklusive hur studien är utformad och vad studien mäter.

Hur är studien utformad?

Designdetaljer

  • Primärt syfte: Förebyggande
  • Tilldelning: Randomiserad
  • Interventionsmodell: Parallellt uppdrag
  • Maskning: Dubbel

Vapen och interventioner

Deltagargrupp / Arm
Intervention / Behandling
Aktiv komparator: Conventional analgesia
Övrig: conventional analgesic regimen
Patients received standard postoperative analgesia consisting of intravenous patient-controlled analgesia (PCA) with morphine following coronary artery bypass graft surgery. The PCA device was initiated in the postoperative period according to institutional analgesia protocols, allowing patient-administered morphine dosing for pain control. Additional rescue analgesics were administered when clinically indicated.
Aktiv komparator: Parasternal block
Procedur: parasternal block
Ultrasound-guided parasternal block was performed bilaterally after induction of general anesthesia in patients undergoing coronary artery bypass graft surgery. Following aseptic skin preparation, a high-frequency linear ultrasound probe was placed parallel to the sternum to identify the parasternal intercostal plane. A block needle was advanced under ultrasound guidance, and local anesthetic was injected into the interfascial plane adjacent to the sternum to provide anterior thoracic wall analgesia. The procedure was performed according to institutional standardized block protocols.
Aktiv komparator: Parasternal block + Adductor canal block
Procedur: Parasternal block + Adductor canal block
In addition to conventional analgesia, patients received ultrasound-guided bilateral parasternal block and adductor canal block after induction of general anesthesia. The parasternal block was performed by injecting local anesthetic into the interfascial plane adjacent to the sternum under ultrasound guidance to provide anterior thoracic wall analgesia. The adductor canal block was performed under ultrasound guidance by depositing local anesthetic within the adductor canal to provide analgesia at the saphenous vein graft harvesting site. All procedures were performed according to standardized institutional protocols.

Vad mäter studien?

Primära resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
Postoperative opioid consumption
Tidsram: At postoperative 0,1, 2, 4, 8, 12, 24, 48, and 72 hours; total morphine consumption at 72 hours
Postoperative opioid consumption will be assessed as the cumulative morphine dose administered via intravenous patient-controlled analgesia (PCA). Morphine consumption will be recorded at predefined postoperative time points, and total morphine consumption will be calculated at 72 hours after surgery.
At postoperative 0,1, 2, 4, 8, 12, 24, 48, and 72 hours; total morphine consumption at 72 hours

Sekundära resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
Postoperative pain scores assessed using the Numeric Rating Scale (NRS)
Tidsram: At postoperative 0, 1, 2, 4, 8, 12, 24, 48, and 72 hours
Postoperative pain intensity will be evaluated using the Numeric Rating Scale (NRS), where 0 indicates no pain and 10 indicates the worst imaginable pain. Pain scores will be recorded at predefined postoperative time points up to 72 hours after surgery.
At postoperative 0, 1, 2, 4, 8, 12, 24, 48, and 72 hours
Quality of Recovery-15 (QoR-15) score
Tidsram: At postoperative 24 and 72 hours
Postoperative recovery quality will be assessed using the Quality of Recovery-15 (QoR-15) questionnaire at 24 and 72 hours after surgery. The QoR-15 is a validated patient-reported outcome measure evaluating multiple domains of postoperative recovery, with higher scores indicating better recovery quality.
At postoperative 24 and 72 hours
Postoperative nausea and vomiting and antiemetic consumption
Tidsram: At postoperative 0, 1, 2, 4, 8, 12, 24, 48, and 72 hours
Postoperative nausea and vomiting (PONV) will be evaluated at predefined postoperative time points using a standardized nausea-vomiting scoring system. The requirement for rescue antiemetic treatment and the total amount of antiemetic medication administered during the first 72 postoperative hours will also be recorded.
At postoperative 0, 1, 2, 4, 8, 12, 24, 48, and 72 hours

Samarbetspartners och utredare

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Sponsor

Zonguldak Bulent Ecevit University

Studieavstämningsdatum

Dessa datum spårar framstegen för inlämningar av studieposter och sammanfattande resultat till ClinicalTrials.gov. Studieposter och rapporterade resultat granskas av National Library of Medicine (NLM) för att säkerställa att de uppfyller specifika kvalitetskontrollstandarder innan de publiceras på den offentliga webbplatsen.

Studera stora datum

Studiestart (Beräknad)

15 juni 2026

Primärt slutförande (Beräknad)

1 april 2027

Avslutad studie (Beräknad)

31 juli 2027

Studieregistreringsdatum

Först inskickad

14 maj 2026

Först inskickad som uppfyllde QC-kriterierna

14 maj 2026

Första postat (Faktisk)

20 maj 2026

Uppdateringar av studier

Senaste uppdatering publicerad (Faktisk)

20 maj 2026

Senaste inskickade uppdateringen som uppfyllde QC-kriterierna

14 maj 2026

Senast verifierad

1 maj 2026

Mer information

Termer relaterade till denna studie

Nyckelord

Ytterligare relevanta MeSH-villkor

Andra studie-ID-nummer

  • AEŞH-EK-2026-053

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