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The effect of combined ultrasound-guided transverse thoracic muscle plane block and rectus sheath plane block on the peri-operative consumption of opioids in open heart surgeries

Article

Last updated: 31 Dec 2024

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Abstract

Background
Patients undergoing heart surgery with a midline sternotomy typically get intravenous opioids as their primary form of post-operative pain management. Due to its possible drawbacks, regional neuraxial anesthesia is still controversial. There have been reports on the impact of rectus sheath plane (RSP) block in conjunction with ultrasound-guided transverse thoracic muscle plane (TTP) block on postoperative pain following sternotomy.
Aim Of The Study
The efficiency of combining TTP and RSP blocks in lowering the targeted patients’ perioperative requirement for opioids, minimizing opioid adverse effects, and attaining a potential Fast-Tract Extubation.
Patients And Methods
50 patients undergoing open cardiac surgery via median sternotomy were randomly assigned to one of two groups in this randomized, prospective, comparative trial. Group (B) got combined ultrasound-guided TTP and RSP blocks, while Group (S) received saline in the same planes before to the incision.
Results
There was no significant difference between the groups for the demographic information, postoperative opioid consumption, or VAS pain scores, however there was a very significant difference between the groups for intraoperative opioid intake and time to extubation.
Conclusion
Combining TTP and RSP blocks has improved fast-track extubation, decreased hemodynamic changes in response to surgical stress, and decreased intraoperative opioid usage. The blocks directed by routine pain score evaluation did not, however, have a significant impact on postoperative opioid use.

DOI

TEJA-2023-0128

Keywords

Transverse thoracic muscle, TTP block, sternotomy, Open Heart Surgeries, Rectus Sheath Block

Authors

First Name

Fady Medhat Mokhtar

Last Name

Nessim

MiddleName

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Affiliation

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Orcid

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First Name

Alaa Eid Mohamed

Last Name

Hassan

MiddleName

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Affiliation

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Email

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City

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Orcid

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First Name

Fahmy Saad Latif

Last Name

Eskander

MiddleName

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Affiliation

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Email

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City

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Orcid

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First Name

Riham Fathy Galal

Last Name

Nady

MiddleName

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Affiliation

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Orcid

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Volume

39

Article Issue

1

Related Issue

51163

Issue Date

2023-12-01

Receive Date

2023-05-19

Publish Date

2023-12-31

Page Start

488

Page End

495

Print ISSN

1110-1849

Online ISSN

1687-1804

Link

https://egja.journals.ekb.eg/article_387936.html

Detail API

https://egja.journals.ekb.eg/service?article_code=387936

Order

387,936

Publication Type

Journal

Publication Title

Egyptian Journal of Anaesthesia

Publication Link

https://egja.journals.ekb.eg/

MainTitle

The effect of combined ultrasound-guided transverse thoracic muscle plane block and rectus sheath plane block on the peri-operative consumption of opioids in open heart surgeries with median sternotomy

Details

Type

Article

Created At

21 Dec 2024