Thoracic Epidural Analgesia and Bilateral Erector Spinae Plane Block on Postoperative Pain in Open Heart Surgeries
Study Details
Study Description
Brief Summary
Postoperative pain negatively effects respiratory functions in open heart surgeries. The aim of the study is to compare the effects of thoracic epidural analgesia (TEA) and erector spinae plane block (ESPB) on postoperative pain and respiratory functions in patients undergoing open heart surgery with sternotomy
| Condition or Disease | Intervention/Treatment | Phase |
|---|---|---|
|
N/A |
Detailed Description
Thoracic epidural catheter was inserted to patients in Group T at the T4-T5 vertebra level before induction of general anesthesia. And then local anesthetic infusion was started until postoperative 48. hours.
Bilateral erector spinae plan block was applied with total 40 ml of local anesthetic solution to patients in Group E at the T4-T5 vertebra level before induction of general anesthesia.
The control group was infused with 1 mcg/kg/min fentanyl during the surgery. In the postoperative period, 1 g paracetamol was infused 4 times a day.
All patients underwent general anesthesia with the same method and medications.
Tramadol/diclofenac was administered to patients with a pain score (NRS) above 4. NRS and tidal volumes (TV) of the patients were measured at 0, 2, 6, 12, 24, 36 and 48. hours after extubation. Postoperative mechanical ventilation durations, intensive care unit and hospital stays, additional analgesic needs and respiratory complications of the patients were recorded.
Study Design
Arms and Interventions
| Arm | Intervention/Treatment |
|---|---|
| Active Comparator: Thoracic epidural analgesia Thoracic epidural analgesia have been started preoperatively and coninuoed until postoperative 48 hours |
Procedure: Thoracic epidural analgesia
Thoracic epidural analgesia was started preoperatively and rest posoperative 48 hours
|
| Active Comparator: Erector spinae plane block Erector spinae plane blockwas applied preoperatively |
Procedure: Erector spinae plane block
Erector spinae plane block was applied preoperatively using local anesthetic
|
| No Intervention: Intravenous opioid analgesia Intravenous opioid analgesia was administered during the surgery |
Outcome Measures
Primary Outcome Measures
- Postoperative pain [Postoperative 48 hours]
Patients were asked about their pain levels. Rating done with VRS (Verbal Rating Scale). Pain levels were evaluated between 0 and 10 points. 0: No pain (the best)….. 10: Unbearable pain (the worst)
- Respiratory functions [Postoperative 48 hours]
Oxygen requirement:If more than 4 l/min oxygen support via face mask is required to maintain peripheral oxygen saturation (SpO2) above 90%, it is defined as oxygen requirement. Tachypnea:more than 20/min Fever: more than 37 C celcius Non invasive mechanical ventilation requirement:To patients whose breathing is impaired after extubation (who have tachypnea and have SpO2 less than 90% despite receiving oxygen support of more than 4 l/min oxygen support via face mask)
Secondary Outcome Measures
- Analgesic requirement. When the VRS was more than 4 points [Postoperative 48 hours]
diclofenac (75 mg), tramadol (50mg)
- Intensive care and hospital stay [postoperative 30 days]
time for Intensive care and hospital (hours and days, respectively)
Eligibility Criteria
Criteria
Inclusion Criteria:
-
Has ASA II-IV score
-
Having open heart surgery
Exclusion Criteria:
-
Having a psychiatric illness
-
Using analgesic medication due to chronic pain
-
Uncooperative
Contacts and Locations
Locations
| Site | City | State | Country | Postal Code | |
|---|---|---|---|---|---|
| 1 | Engin Ertürk | Ortahisar | Trabzon | Turkey | 61080 |
Sponsors and Collaborators
- Karadeniz Technical University
Investigators
- Principal Investigator: Engin Ertürk, Prof. Dr, Karadeniz Technical University, Medical Faculty, Anesthesiology and Intensive Care
Study Documents (Full-Text)
None provided.More Information
Publications
None provided.- 2023/184