Parasternal vs. Combined Parasternal-Serratus Block in Cardiac Surgery

NCT07522229 | Recruiting

• 1 other identifier: HanedanBlock-01
• Study Type: interventional
• Target: 70
• Locations: 1 country
• Sites: 1

Brief Summary

This randomized controlled trial aims to compare the analgesic efficacy of parasternal intercostal plane block (PIPB) alone versus the combination of parasternal intercostal plane block and serratus anterior plane block (SAPB) in adult patients undergoing elective cardiac surgery via sternotomy. Seventy patients will be randomly assigned to two groups: Group A will receive bilateral PIPB, while Group B will receive bilateral PIPB combined with unilateral SAPB on the side of chest drain placement. Postoperative pain will be assessed using the visual analog scale (VAS) at rest and during movement over the first 24 hours. Secondary outcomes include time to extubation, length of stay in the intensive care unit, and time to mobilization. The study is designed as a prospective, single-center, single-blind trial conducted at Akdeniz University Hospital, Antalya, Turkey. We hypothesize that the combined block technique will provide superior analgesia, reduce opioid consumption, and improve recovery parameters compared to PIPB alone

Conditions

Postoperative Pain; Cardiac Surgery

Keywords

Parasternal Intercostal Plane Block; Serratus Anterior Plane Block; Cardiac Surgery Analgesia

Outcome Measures

Primary Outcomes (1)

• Postoperative pain intensity (VAS)

  Pain intensity measured using the Visual Analog Scale (VAS), ranging from 0 to 10, where 0 indicates no pain and 10 indicates the worst imaginable pain.

  24 hours after surgery

Secondary Outcomes (3)

• Time to extubation

  Postoperative period until extubation.

• Length of stay in the intensive care unit (ICU)

  From ICU admission after surgery until ICU discharge, up to 30 days

• Time to first mobilization

  From ICU admission after surgery until the first mobilization attempt, assessed up to 30 days

Other Outcomes (2)

• Number of rescue opioid administrations

  Within the first 24 hours after surgery

• Total dose of rescue opioids

  Within the first 24 hours after surgery

Study Arms (2)

Parasternal Intercostal Plane Block

EXPERIMENTAL

Patients will receive bilateral parasternal intercostal plane block with bupivacaine under ultrasound guidance, plus standard intravenous morphine at the end of surgery.

Procedure: Parasternal Intercostal Plane Block; Procedure: Parasternal Intercostal Plane Block + Serratus Anterior Plane Block

Parasternal + Serratus Plane Block

EXPERIMENTAL

Patients will receive bilateral parasternal intercostal plane block combined with unilateral serratus anterior plane block (on the chest drain side), using bupivacaine under ultrasound guidance.

Procedure: Parasternal Intercostal Plane Block; Procedure: Parasternal Intercostal Plane Block + Serratus Anterior Plane Block

Interventions

Parasternal Intercostal Plane Block + Serratus Anterior Plane Block PROCEDURE

Bilateral parasternal intercostal plane block will be performed as in Arm 1. In addition, a unilateral serratus anterior plane block will be performed under ultrasound guidance at the 4th-6th intercostal level on the side of chest drain placement, with 0.25% bupivacaine (5-7 mL per injection site, not exceeding 2.5 mg/kg).

Parasternal + Serratus Plane Block; Parasternal Intercostal Plane Block

Parasternal Intercostal Plane Block PROCEDURE

Bilateral parasternal intercostal plane block will be performed under ultrasound guidance at the 3rd and 5th intercostal spaces using 0.25% bupivacaine (total 30 mL). At the end of surgery, intravenous morphine (0.1 mg/kg) will be administered.

Parasternal + Serratus Plane Block; Parasternal Intercostal Plane Block

Eligibility Criteria

• Age: 18 Years+
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

Sponsors & Collaborators

• BEDİA MİNE HANEDAN: lead

Study Sites (1)

SBÜ Konya Şehir Hastanesi

Konya, Turkey (Türkiye)

RECRUITING

Related Publications (2)

• Kuwano K, Kawasaki M, Maeyama T, Hagimoto N, Nakamura N, Shirakawa K, Hara N. Soluble form of fas and fas ligand in BAL fluid from patients with pulmonary fibrosis and bronchiolitis obliterans organizing pneumonia. Chest. 2000 Aug;118(2):451-8. doi: 10.1378/chest.118.2.451.

  PMID: 10936140 BACKGROUND

• Servidio AG, Capata G, Levantino L, Riccio G, Contorno S, Barbi E, Maschio M. COVID-19 lockdown beneficial effects on lung function in a cohort of cystic fibrosis patients. Ital J Pediatr. 2021 Jan 18;47(1):12. doi: 10.1186/s13052-021-00970-4. No abstract available.

  PMID: 33461569 BACKGROUND

MeSH Terms

Conditions

Pain, Postoperative

Condition Hierarchy (Ancestors)

Postoperative Complications; Pathologic Processes; Pathological Conditions, Signs and Symptoms; Pain; Neurologic Manifestations; Signs and Symptoms

Study Officials

• BEDİA MİNE HANEDAN

  Konya şehir hastanesi

  PRINCIPAL INVESTIGATOR

Central Study Contacts

BEDİA MİNE HANEDAN

CONTACT

05059269595; bediamine@hotmail.com

BULENT HANEDAN

CONTACT

05053473024; bhanedan@hotmail.com

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR INVESTIGATOR
• PI Title: Principal Investigator

Study Record Dates

• First Submitted: September 25, 2025
• First Posted: April 13, 2026
• Study Start: October 5, 2025
• Primary Completion: April 5, 2026
• Study Completion (Estimated): May 5, 2026
• Last Updated: April 16, 2026

Record last verified: 2026-04

Locations

TU (1)