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The Analgesic Effect of Ultrasound-guided Bilateral Pecto-intercostal Fascial Plane Block on Sternal Wound Pain after Open Heart Surgeries: A Randomized Controlled Study

Clin J Pain. 2022 Feb 8. doi: 10.1097/AJP.0000000000001022. Online ahead of print.

ABSTRACT

OBJECTIVES: We aimed to evaluate the analgesic efficacy of ultrasound-guided bilateral pecto-intercostal fascial plane block after open-heart surgeries.

METHODS: Seventy patients aged above 18 years and scheduled for on-pump coronary artery bypass grafting or valve replacement or both through median sternotomy were enrolled in this study. Patients were randomly allocated into two groups of each 35 (block group or control group): Block group, which had the block performed through twenty milliliters of a solution of 0.25% bupivacaine plus epinephrine (5▒mcg/mL), and Control group, dry needling was done. The primary outcome was the 24-hour cumulative morphine consumption. The secondary outcomes were time to the first analgesic request, pain score, quality of oxygenation, ICU stays, and hospital stay.

RESULTS: The cumulative morphine consumption in the first 24 hours was significantly lower in the block group, with a mean difference of -3.54 (95% CI=-6.55 to -0.53; P=0.015). In addition, the median estimate time to the first analgesic request was significantly longer in the block group than in the control group. Finally, during the postoperative period (4-24▒h), mean sternal wound Objective pain scores were, on average, 0.58 units higher in the block group.

CONCLUSION: PIFB is an effective technique in reducing morphine consumption and controlling post-sternotomy pain after cardiac surgeries. Also, it may have a role in better postoperative respiratory outcomes.

PMID:35132025 | DOI:10.1097/AJP.0000000000001022

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