PDF(Pubmed)
Abstract：
BACKGROUND: Severe pain occurs after cardiac surgery in the sternum and chest tubes sites. Although analgesia targeting the sternum is often prioritized, the analgesia of the drain site is sometimes overlooked. This study of patients undergoing coronary artery bypass grafting (CABG) aimed to provide optimized analgesia for both the sternum and the chest tubes area by combining parasternal block (PSB) and serratus anterior plane block (SAPB).
METHODS: Ethics committee approval (E.Kurul-E2-24-6176, 07/02/2024) was received for the study. Then, the trial was registered on www.
RESULTS: gov ( https://clinicaltrials.gov/ ) under the identifier NCT05427955 on 17/03/2024. Twenty patients between the ages of 18-80, with ASA physical status classification II-III, undergoing coronary artery bypass grafting CABG with sternotomy, were included. While the patients were under general anesthesia, PSB was performed through the second and fourth intercostal spaces, and SAPB was performed over the sixth rib. The primary outcome was VAS (Visual Analog Scale) during the first 12 h after extubation. The secondary outcomes were intraoperative remifentanil consumption and block-related side effects.
RESULTS: The average age of the patients was 64 years. Five patients were female, and 15 were male. For the sternum area, only one patient had resting VAS scores of 4, while the VAS scores for resting for the other patients were below 4. For chest tubes area, only two patients had resting VAS scores of 4 or above, while the resting VAS scores for the other patients were below 4. The patients\' intraoperative remifentanil consumption averaged 2.05 mg. No side effects related to analgesic protocol were observed in any of the patients.
CONCLUSIONS: In this preliminary study where PSB and SAPB were combined in patients undergoing CABG, effective analgesia was achieved for the sternum and chest tubes area.
METHODS: Ethics committee approval (E.Kurul-E2-24-6176, 07/02/2024) was received for the study. Then, the trial was registered on www.
RESULTS: gov ( https://clinicaltrials.gov/ ) under the identifier NCT05427955 on 17/03/2024. Twenty patients between the ages of 18-80, with ASA physical status classification II-III, undergoing coronary artery bypass grafting CABG with sternotomy, were included. While the patients were under general anesthesia, PSB was performed through the second and fourth intercostal spaces, and SAPB was performed over the sixth rib. The primary outcome was VAS (Visual Analog Scale) during the first 12 h after extubation. The secondary outcomes were intraoperative remifentanil consumption and block-related side effects.
RESULTS: The average age of the patients was 64 years. Five patients were female, and 15 were male. For the sternum area, only one patient had resting VAS scores of 4, while the VAS scores for resting for the other patients were below 4. For chest tubes area, only two patients had resting VAS scores of 4 or above, while the resting VAS scores for the other patients were below 4. The patients\' intraoperative remifentanil consumption averaged 2.05 mg. No side effects related to analgesic protocol were observed in any of the patients.
CONCLUSIONS: In this preliminary study where PSB and SAPB were combined in patients undergoing CABG, effective analgesia was achieved for the sternum and chest tubes area.
摘要：
背景：心脏手术后在胸骨和胸管部位发生严重疼痛。尽管以胸骨为目标的镇痛通常是优先考虑的，排水部位的镇痛有时被忽视。这项对接受冠状动脉旁路移植术（CABG）的患者进行的研究旨在通过结合胸骨旁阻滞（PSB）和前锯肌平面阻滞（SAPB）为胸骨和胸管区域提供优化的镇痛。
方法：伦理委员会批准(E.Kurul-E2-24-6176,07/02/2024)用于研究。然后，该试验已在www上注册。
结果：gov（https://clinicaltrials.gov/），标识符为17/03/2024NCT05427955。20名年龄在18-80岁之间的患者，ASA身体状况II-III级，胸骨切开术行冠状动脉旁路移植术，包括在内。当患者处于全身麻醉状态时，PSB是通过第二和第四肋间空间进行的，SAPB在第六根肋骨上进行。主要结果是拔管后最初12小时的VAS（视觉模拟量表）。次要结果为术中瑞芬太尼消耗量和阻滞相关副作用。
结果：患者的平均年龄为64岁。五名患者是女性，15个是男性。对于胸骨区域，只有1例患者静息期VAS评分为4分,其他患者静息期VAS评分低于4分.对于胸管区域，只有两名患者的静息VAS评分为4分或以上，而其他患者的静息VAS评分低于4。患者术中瑞芬太尼平均消耗量为2.05mg。在任何患者中均未观察到与镇痛方案相关的副作用。
结论：在这项初步研究中，PSB和SAPB联合用于CABG患者，胸骨和胸管区域实现了有效的镇痛。
方法：伦理委员会批准(E.Kurul-E2-24-6176,07/02/2024)用于研究。然后，该试验已在www上注册。
结果：gov（https://clinicaltrials.gov/），标识符为17/03/2024NCT05427955。20名年龄在18-80岁之间的患者，ASA身体状况II-III级，胸骨切开术行冠状动脉旁路移植术，包括在内。当患者处于全身麻醉状态时，PSB是通过第二和第四肋间空间进行的，SAPB在第六根肋骨上进行。主要结果是拔管后最初12小时的VAS（视觉模拟量表）。次要结果为术中瑞芬太尼消耗量和阻滞相关副作用。
结果：患者的平均年龄为64岁。五名患者是女性，15个是男性。对于胸骨区域，只有1例患者静息期VAS评分为4分,其他患者静息期VAS评分低于4分.对于胸管区域，只有两名患者的静息VAS评分为4分或以上，而其他患者的静息VAS评分低于4。患者术中瑞芬太尼平均消耗量为2.05mg。在任何患者中均未观察到与镇痛方案相关的副作用。
结论：在这项初步研究中，PSB和SAPB联合用于CABG患者，胸骨和胸管区域实现了有效的镇痛。
