Ultrasound-Guided Parasternal/Rectus Sheath Block vs Erector Spinae Plane Block for Pain Control in Cardiac Surgery

NCT07692659 | Not Yet Recruiting

• 1 other identifier: ECC-2025-64
• Study Type: interventional
• Target: 50
• Locations: 0 countries
• Sites: N/A

Brief Summary

The researchers are working to improve recovery after heart surgery by reducing reliance on opioids. Newer regional anesthesia techniques can provide strong pain relief with fewer risks, but the choice of method depends on each patient's condition, medications, and surgical plan

Conditions

Perioperative Analgesia; Analgesia; Regional Block Technique

Keywords

Parasternal block; Rectus sheath block; ESPB; Analgesia

Outcome Measures

Primary Outcomes (1)

• Numeric rating score

  postoperative pain scores using Numerical Rating Scale (NRS) with 0 meaning no pain and 10 meaning the worst pain level

  24 hours

Secondary Outcomes (4)

• postoperative opioid consumption

  24 hours

• extubation time

  immediate postoperative

• first time to request analgesia

  24 hours

• peri-operative hemodynamics

  intraoperative and 24 hours

Study Arms (2)

Parasternal/ Rectus sheath

EXPERIMENTAL

Patients will receive Parasternal and rectus sheath blocks; with injection of 10 ml bupivacaine 0.25% in each side after confirmation of needle position. Both parasternal and rectus heath blocks will be performed bilaterally

Procedure: Parasternal/ Rectus sheath block

Erector Spinae Plane Block

EXPERIMENTAL

The patients will receive a bilateral ESPB with an injection of 20 ml of bupivacaine 0.25%.

Procedure: Erector spinae plane block

Interventions

Parasternal/ Rectus sheath block PROCEDURE

the parasternal block will be performed parasternally at the level of fifth rib to the plane between the pectoralis major and the internal intercostal muscle. The rectus sheath block will be performed through injection in the plane posterior to the rectus abdominis muscle and anterior to the posterior rectus sheath

Parasternal/ Rectus sheath

Erector spinae plane block PROCEDURE

injection above the transverse process

Erector Spinae Plane Block

Eligibility Criteria

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

You may qualify if:

• Both sexes,
• ASA III-IV patients
• body mass index between 20- 35 kg/m2
• adult patients above 18 years old will be included in the study

You may not qualify if:

• Patients with global hypokinesia
• ejection fraction \< 40%
• low platelet count
• coagulation impairment
• deformity in the vertebral column
• severe renal and hepatic impairment
• any known allergy to the drugs used

Sponsors & Collaborators

• National Cancer Institute, Egypt: lead
• Saudi German Hospital - Madinah: collaborator

MeSH Terms

Conditions

Agnosia

Condition Hierarchy (Ancestors)

Perceptual Disorders; Neurobehavioral Manifestations; Neurologic Manifestations; Nervous System Diseases; Signs and Symptoms; Pathological Conditions, Signs and Symptoms

Study Officials

• Walaa Y Elsabeeny, MD

  A Professor of Anesthesia, Critical Care and Pain Management, National Cancer Institute, Cairo University

  PRINCIPAL INVESTIGATOR

Central Study Contacts

Walaa Y Elsabeeny, MD

CONTACT

01007798466; walaa.elsabeeny@nci.cu.edu.eg

Mostafa A Ibrahim, MD

CONTACT

+966541227090; MAbIbrahim@sghgroup.net

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: DOUBLE
• Who Masked: PARTICIPANT, OUTCOMES ASSESSOR
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Assistant professor of Anesthesia, Surgical Critical Care and Pain management

Model Details: 2

Study Record Dates

• First Submitted: July 2, 2026
• First Posted: July 9, 2026
• Study Start: July 1, 2026
• Primary Completion (Estimated): June 1, 2027
• Study Completion (Estimated): June 1, 2027
• Last Updated: July 13, 2026

Record last verified: 2026-07