Comparison of Sensory Analysis After Superficial and Deep Parasternal Intercostal Plane Blocks

NCT06559683 | Completed

• 1 other identifier: SensoryParasternal
• Study Type: observational
• Target: 33
• Locations: 1 country
• Sites: 1

Brief Summary

Postoperative pain following cardiac surgery is a common issue that can negatively impact patients' quality of life. Effective perioperative pain management is crucial to improving patient outcomes. Pain is typically most intense during the first two postoperative days, and inadequate management can lead to chronic pain, further diminishing quality of life. Recent advances in ultrasound-guided regional anesthesia, including superficial and deep parasternal intercostal plane blocks, have enhanced acute pain control. These blocks aim to provide analgesia by targeting the anterior cutaneous branches of the T2-6 thoracic nerves. While their efficacy is recognized, sensory evaluation and dermatomal analysis remain unexplored. Cadaver studies suggest that the deep block may cover more parasternal space than the superficial block.

Conditions

Pain, Postoperative

Keywords

analgesia; pain Management; sensory assessment

Outcome Measures

Primary Outcomes (1)

• Extent of Sensory Blockade Measured by Cold Sensation Testing Across the Anterior Chest Wall Following Deep and Superficial Parasternal Intercostal Plane Blocks.

  Participants will undergo sensory assessment using standardized cold sensation test at 30 minutes post-block to evaluate the maximum sensory blockade. The data will be recorded as the area of sensory loss (in cm) along the anterior chest wall, and the results will be aggregated to report the maximum area of sensory blockade achieved for both deep and superficial blocks. Cold sensation will be categorized as Normal Cold, Reduced Cold, or No Cold Sensation. A successful block is defined as a complete loss or reduction of cold sensitivity.

  30 minutes after the blocks

Secondary Outcomes (3)

• Regression of Sensory Blockade at 12 and 24 Hours Post-Block

  Postoperative Day 1

• Opioid Consumption

  Postoperative Day 1

• Acute pain scores

  Postoperative Day 1

Study Arms (2)

Deep Parasternal

Patients scheduled for open-heart surgery will receive a deep parasternal intercostal plane block preoperatively, and sensory block status will be evaluated 30 minutes later using small ice tubes.

Other: Sensory Assessment

Superficial Parasternal

Patients scheduled for open-heart surgery will receive a superficial parasternal intercostal plane block preoperatively, and sensory block status will be evaluated 30 minutes later using small ice tubes.

Other: Sensory Assessment

Interventions

Sensory Assessment OTHER

Patients scheduled for open-heart surgery will receive a deep/superficial parasternal intercostal plane block preoperatively, and sensory block status will be evaluated after 30 minutes.

Deep Parasternal; Superficial Parasternal

Eligibility Criteria

• Age: 18 Years - 85 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

Patients scheduled for median sternotomy as part of open-heart surgery and who have received either a superficial or deep parasternal intercostal plane block will be enrolled

You may qualify if:

• Patients who will undergo effective open heart surgery with median sternotomy
• Patients who have undergone superficial or deep parasternal intercostal plane block

You may not qualify if:

• Patients with severe psychiatric illnesses such as psychosis or dementia that would prevent communication with the patient
• Patients who do not want to participate in the study
• Redo surgeries
• Patients whose block is considered unsuccessful with the cold application test at the 30th minute
• Patients who cannot be extubated 12 hours post-block.

Sponsors & Collaborators

• Ondokuz Mayıs University: lead

Study Sites (1)

Ondokuz Mayis University

Samsun, Turkey (Türkiye)

Location

MeSH Terms

Conditions

Pain, Postoperative; Agnosia

Condition Hierarchy (Ancestors)

Postoperative Complications; Pathologic Processes; Pathological Conditions, Signs and Symptoms; Pain; Neurologic Manifestations; Signs and Symptoms; Perceptual Disorders; Neurobehavioral Manifestations; Nervous System Diseases

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: PROSPECTIVE
• Target Duration: 1 Day
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: associate professor

Study Record Dates

• First Submitted: August 13, 2024
• First Posted: August 19, 2024
• Study Start: September 14, 2024
• Primary Completion: February 1, 2025
• Study Completion: February 27, 2025
• Last Updated: March 5, 2025

Record last verified: 2025-02

Locations

TU (1)