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).
研究概览
研究类型
注册 (实际的)
联系人和位置
学习地点
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Montpellier、法国、34295
- Uh Montpellier
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参与标准
资格标准
适合学习的年龄
接受健康志愿者
有资格学习的性别
取样方法
研究人群
"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.
描述
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
学习计划
研究是如何设计的？
设计细节
- 观测模型：队列
- 时间观点：追溯
队列和干预
团体/队列 |
干预/治疗 |
|---|---|
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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.
其他名称：
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研究衡量的是什么？
主要结果指标
结果测量 |
措施说明 |
大体时间 |
|---|---|---|
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cumulative morphine consumption
大体时间：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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次要结果测量
结果测量 |
措施说明 |
大体时间 |
|---|---|---|
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Postoperative pain assessed
大体时间：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
大体时间：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
大体时间：postoperative day 7
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Occurrence of prurit
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postoperative day 7
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rate of Delirium
大体时间：postoperative day 7
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rate of Delirium
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postoperative day 7
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rate of Constipation
大体时间：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
大体时间：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
大体时间：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
大体时间：day 20
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Pleural drain duration
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day 20
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Urinary catheter duration
大体时间：day 20
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Urinary catheter duration
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day 20
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Duration of hospitalization in ICU
大体时间：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
大体时间：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
大体时间：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
大体时间：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
大体时间：until postoperative day 7
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acute kidney injury
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until postoperative day 7
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合作者和调查者
调查人员
- 首席研究员：Pierre Sentenac, MD, PhD、Uh Montpellier
研究记录日期
研究主要日期
学习开始 (实际的)
初级完成 (实际的)
研究完成 (实际的)
研究注册日期
首次提交
首先提交符合 QC 标准的
首次发布 (实际的)
研究记录更新
最后更新发布 (实际的)
上次提交的符合 QC 标准的更新
最后验证
更多信息
与本研究相关的术语
关键字
其他研究编号
- RECHMPL19_0582
计划个人参与者数据 (IPD)
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IPD 计划说明
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