Multimodal Fascial Plane Block for Postoperative Analgesia in Isolated CABG Surgery

NCT07587320 | Recruiting

• 1 other identifier: GY-CABG-2026
• Study Type: interventional
• Target: 56
• Locations: 1 country
• Sites: 1

Brief Summary

Postoperative pain following coronary artery bypass grafting (CABG) via median sternotomy remains a significant clinical problem and is associated with increased opioid consumption and postoperative complications. Fascial plane blocks have emerged as part of multimodal analgesia strategies in cardiac surgery. This prospective, randomized, controlled, single-blinded study aims to evaluate the effect of an induction-time multimodal fascial plane block package-consisting of bilateral superficial parasternal block, bilateral serratus anterior plane block, and adductor canal block-on postoperative analgesia, opioid consumption, and clinical outcomes in patients undergoing elective isolated CABG with saphenous vein graft harvesting. Patients will be randomized in a 1:1 ratio to receive either the multimodal fascial plane block package in addition to standard postoperative analgesia or standard postoperative analgesia alone. The primary outcome is total opioid consumption within the first 24 postoperative hours. Secondary outcomes include pain scores, time to first opioid requirement, extubation time, postoperative pulmonary complications, atrial fibrillation, and length of ICU and hospital stay.

Conditions

Coronary Artery Bypass Graft (CABG); Postoperative Pain; Sternotomy

Keywords

Parasternal Block; Serratus Anterior Plane Block; Adductor Canal Block; Opioid Consumption; Multimodal Analgesia; Randomized Controlled Trial; Cardiac Surgery; Fascial Plane Block; Coronary Artery Bypass Graft

Outcome Measures

Primary Outcomes (1)

• Total opioid consumption within the first 48 postoperative hours

  Total cumulative tramadol consumption (mg) during the first 48 hours following surgery.

  Through 48 hours after surgery

Secondary Outcomes (3)

• Postoperative pain intensity scores

  At 6, 12, 24, and 48 hours after surgery

• Time to first rescue analgesic requirement

  Within 48 hours after surgery

• Extubation time

  From ICU admission to extubation, assessed through 24 hours after surgery

Study Arms (2)

Multimodal Fascial Plane Block Group

EXPERIMENTAL

Participants will receive a multimodal fascial plane block package consisting of bilateral superficial parasternal block, bilateral serratus anterior plane block, and adductor canal block following induction of general anesthesia and before surgical incision, in addition to standard perioperative analgesia.

Procedure: Multimodal Fascial Plane Block Package

Standard Analgesia Group

ACTIVE COMPARATOR

Participants will receive standard perioperative and postoperative analgesia without regional fascial plane block intervention.

Other: Standard Postoperative Analgesia

Interventions

Multimodal Fascial Plane Block Package PROCEDURE

Participants will receive ultrasound-guided bilateral superficial parasternal block, bilateral serratus anterior plane block, and adductor canal block after induction of general anesthesia and before surgical incision.

Multimodal Fascial Plane Block Group

Standard Postoperative Analgesia OTHER

Participants will receive standard institutional perioperative and postoperative analgesia without regional fascial plane block.

Standard Analgesia Group

Eligibility Criteria

• Age: 18 Years - 80 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Age between 18 and 80 years
• Scheduled for elective isolated coronary artery bypass grafting (CABG) with saphenous vein graft harvesting
• ASA physical status II-IV
• Ability to provide written informed consent

You may not qualify if:

• Known coagulopathy or contraindication to regional anesthesia
• Use of anticoagulant therapy precluding regional block
• Known allergy to local anesthetics
• Local infection at planned block sites
• Chronic opioid use or chronic pain syndrome
• Emergency surgery
• Redo sternotomy
• Severe neurological disorder affecting pain assessment

Sponsors & Collaborators

• Saglik Bilimleri Universitesi: lead

Study Sites (1)

University of Health Sciences, Diyarbakir Gazi Yasargil Training and Research Hospital

Diyarbakır, Diyarbakır, Turkey (Türkiye)

RECRUITING

Related Publications (3)

• Kalli A, Vistbacka J, Moilanen E, Jarvela K, Mennander A. Superficial Parasternal Intercostal Plane Block and Full Sternotomy; A Randomized Trial. Eur J Cardiothorac Surg. 2025 Jul 1;67(7):ezaf226. doi: 10.1093/ejcts/ezaf226.

  PMID: 40627369 BACKGROUND

• Zhang J, Luo F, Zhang X, Xue Y. Ultrasound-Guided Continuous Parasternal Intercostal Block Relieves Postoperative Pain After Open Cardiac Surgery: A Case Series. J Cardiothorac Vasc Anesth. 2022 Jul;36(7):2051-2054. doi: 10.1053/j.jvca.2021.05.028. Epub 2021 May 21.

  PMID: 34183252 BACKGROUND

• Zengin EN, Yigit H, Cobas M, Salman N, Asli Demir Z. The analgesic effects of combined bilateral parasternal block and serratus anterior plane block for coronary artery bypass grafting surgery. BMC Anesthesiol. 2024 Aug 5;24(1):274. doi: 10.1186/s12871-024-02659-7.

  PMID: 39103782 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

• Selen Topalel, MD

  University of Health Sciences, Diyarbakir Gazi Yasargil Training and Research Hospital

  PRINCIPAL INVESTIGATOR

Central Study Contacts

Selen Topalel, MD

CONTACT

+90 533 506 33 20; selentopalel26@gmail.com

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Masking Details: Outcome assessors responsible for postoperative pain scoring and data collection will be blinded to group allocation.
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Anesthesiologist

Model Details: Participants will be randomized in a 1:1 ratio to receive either a multimodal fascial plane block package or standard perioperative analgesia without regional block. Randomization will be performed using a computer-generated sequence. The two groups will be followed in parallel.

Study Record Dates

• First Submitted: February 14, 2026
• First Posted: May 14, 2026
• Study Start: January 1, 2026
• Primary Completion (Estimated): August 1, 2026
• Study Completion (Estimated): September 1, 2026
• Last Updated: May 14, 2026

Record last verified: 2026-05

Data Sharing

• IPD Sharing: Will not share

Locations

TU (1)