Ultrasound Guided Bilateral Transverse Thoracic Plane Block for Patient Undergoing Cardiac Surgery
Authors/Creators
- 1. Junior Resident, Department of Anaesthesia, SAMC and PGI, Indore, MP
- 2. Assistant Professor, Department of Forensic Medicine, Government Medical College, Nagpur, Maharashtra
- 3. PGMO Anaesthesia, District Hospital, Shivpuri, MP
- 4. Assistant Professor, Department of Anesthesia, SAMC and PGI, Indore, Madhya Pradesh
Description
Background and Objectives: The management of postoperative pain in patients following cardiac surgery mostly relied on opioids. However, the desired outcomes could not be attained due to the adverse consequences associated with opioids. The implementation of the multimodal analgesic strategy has been developed to mitigate the undesirable consequences of opioids and provide optimal pain relief. The objective of this study was to assess the impact of ultrasound-guided bilateral thoracic plane block on patients having cardiac surgery. Material and Methods: This prospective, randomized, double-blind study was conducted in the Department of Anesthesiology and Critical Care, Sri Aurobindo Institute of Medical Sciences Hospital, Indore (M.P) among 100 Patients of 18-70 years scheduled for elective cardiac surgeries. After explaining the protocol to all patients, a written and informed consent was taken from all patients. The patients were allocated into two groups using computer-generated random numbers: the Intervention group [Group T], that had a bilateral transversus thoracic muscle plane block guided by ultrasonography with 20ml of 0.25% ropivacaine, and the Control group [Group C], which underwent a sham block. Primary outcome was to observe the pain score and first need of rescue analgesic inj. Tramadol. The secondary outcomes were pain score, Total analgesic requirement in 24 hr, time to extubation, and ICU stays. Results: The control group had a considerably shorter time prior to the first request for pain management (median 3 hours) compared to group T (median 14 hours). Within the 0.5-24 hour period after surgery, the group T observed a decrease of 1.86 units in pain scores at rest. The estimated decrease was -1.80, with a 95% confidence interval ranging from -2.14 to -1.45. The t-value was -10.323, and the p-value was less than 0.0001. Postoperative tramadol consumption was found to be significantly lower in Group T (p < 0.001). Conclusion: The bilateral transversus thoracic muscle plane block (TTMPB) is a very promising and successful method for minimizing opioid consumption and managing post-sternotomy pain in patients who underwent cardiac surgery.
Abstract (English)
Background and Objectives: The management of postoperative pain in patients following cardiac surgery mostly relied on opioids. However, the desired outcomes could not be attained due to the adverse consequences associated with opioids. The implementation of the multimodal analgesic strategy has been developed to mitigate the undesirable consequences of opioids and provide optimal pain relief. The objective of this study was to assess the impact of ultrasound-guided bilateral thoracic plane block on patients having cardiac surgery. Material and Methods: This prospective, randomized, double-blind study was conducted in the Department of Anesthesiology and Critical Care, Sri Aurobindo Institute of Medical Sciences Hospital, Indore (M.P) among 100 Patients of 18-70 years scheduled for elective cardiac surgeries. After explaining the protocol to all patients, a written and informed consent was taken from all patients. The patients were allocated into two groups using computer-generated random numbers: the Intervention group [Group T], that had a bilateral transversus thoracic muscle plane block guided by ultrasonography with 20ml of 0.25% ropivacaine, and the Control group [Group C], which underwent a sham block. Primary outcome was to observe the pain score and first need of rescue analgesic inj. Tramadol. The secondary outcomes were pain score, Total analgesic requirement in 24 hr, time to extubation, and ICU stays. Results: The control group had a considerably shorter time prior to the first request for pain management (median 3 hours) compared to group T (median 14 hours). Within the 0.5-24 hour period after surgery, the group T observed a decrease of 1.86 units in pain scores at rest. The estimated decrease was -1.80, with a 95% confidence interval ranging from -2.14 to -1.45. The t-value was -10.323, and the p-value was less than 0.0001. Postoperative tramadol consumption was found to be significantly lower in Group T (p < 0.001). Conclusion: The bilateral transversus thoracic muscle plane block (TTMPB) is a very promising and successful method for minimizing opioid consumption and managing post-sternotomy pain in patients who underwent cardiac surgery.
Files
IJPCR,Vol15,Issue12,Article229.pdf
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Additional details
Dates
- Accepted
-
2023-11-30
Software
- Repository URL
- https://impactfactor.org/PDF/IJPCR/15/IJPCR,Vol15,Issue12,Article229.pdf
- Development Status
- Active
References
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