Efficacy of Multiple Nerve Blocks on the Recovery of Patients Undergoing Off Pump CABG Surgeries

NCT07794527 | Recruiting DMC

• 1 other identifier: FMASU MD362/2025
• Study Type: interventional
• Target: 30
• Locations: 1 country
• Sites: 1

Brief Summary

In cardiac surgery patients , effective pain control is crucial to support early extubation, mobilization, and cognitive recovery, yet systemic opioids carry substantial risks such as respiratory depression, delirium, and delayed rehabilitation. While regional fascial plane blocks offer a safer, opioid-sparing alternative, no single technique provides complete analgesia for the complex and multi-dermatomal pain generated by sternotomy, graft harvesting, chest wall retraction, and drain sites. Therefore, a multimodal approach combining blocks such as parasternal nerve block , rectus sheath nerve block and femoral nerve block , may cover most of areas expected to be sources of intraoperative and post-operative pain in cardiac surgery patients.

Conditions

Ischemic Heart Disease (IHD); Off-pump Coronary Artery Bypass; Regional Block for Pain Control

Outcome Measures

Primary Outcomes (1)

• Time to Extubation

  Defined as the interval (in hours) from transferal to ICU to successful tracheal extubation

  from transferal to ICU until successful tracheal extubation assessed during post operative ICU stay up to 48 hours

Study Arms (2)

Group A (intervention)

ACTIVE COMPARATOR

Patients in this group will receive standardized general anaesthesia with a preemptive bilateral superficial parasternal nerve block using 20 mL of 0.25% bupivacaine per side, in combination with a rectus sheath block (RSB) using 10 mL of 0.25% bupivacaine per side. and femoral nerve block at the side of harvesting using 10 mL of 0.25% bupivacaine.

Procedure: regional nerve block with local anesthesia

Group B ( control)

PLACEBO COMPARATOR

Patients will receive standardized general anesthesia with placebo (saline) injections administered in the same anatomical planes.

Procedure: Placebo

Interventions

regional nerve block with local anesthesia PROCEDURE

Patients will receive bilateral superficial parasternal nerve block using 20 mL of 0.25% bupivacaine per side, in combination with a rectus sheath block (RSB) using 10 mL of 0.25% bupivacaine per side. and femoral nerve block at the side of harvesting using 10 mL of 0.25% bupivacaine.

Group A (intervention)

Placebo PROCEDURE

Patients will receive placebo (saline) injections administered in the same anatomical planes.

Group B ( control)

Eligibility Criteria

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

You may qualify if:

• o Scheduled for elective off-pump coronary artery bypass graft (OPCAB) surgery via median sternotomy
• American Society of Anesthesiologists (ASA) physical status III - IV
• Ability to provide informed consent

You may not qualify if:

• o Emergency or redo cardiac surgery
• On-pump CABG or concomitant valve or aortic procedures
• Known allergy to local anesthetics or study drugs
• Coagulopathy or ongoing anticoagulant therapy contraindicating regional block
• Preoperative chronic opioid use or opioid dependency
• Neurologic or psychiatric conditions interfering with pain assessment
• Infection at the block injection site
• Severe hepatic or renal impairment
• Body mass index (BMI) \> 40 kg/m²
• Inability to understand or cooperate with pain scoring or postoperative care.

Sponsors & Collaborators

• Ain Shams University: lead

Study Sites (1)

Ain shams university hospitals

Cairo, Egypt

RECRUITING

MeSH Terms

Conditions

Myocardial Ischemia

Interventions

Anesthesia, Local

Condition Hierarchy (Ancestors)

Heart Diseases; Cardiovascular Diseases; Vascular Diseases

Intervention Hierarchy (Ancestors)

Anesthesia, Conduction; Anesthesia; Anesthesia and Analgesia

Study Officials

• Sherif S Sultan, MD

  faculty of medicine Ain Shams university

  STUDY DIRECTOR

Central Study Contacts

Abdelrahman H Ashour

CONTACT

+2-1010184467; AbdelrahmanAshour@med.asu.edu.eg

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: QUADRUPLE
• Who Masked: PARTICIPANT, CARE PROVIDER, INVESTIGATOR, OUTCOMES ASSESSOR
• Purpose: PREVENTION
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: April 2, 2026
• First Posted: August 31, 2026
• Study Start: September 10, 2026
• Primary Completion (Estimated): March 31, 2027
• Study Completion (Estimated): April 7, 2027
• Last Updated: August 31, 2026

Record last verified: 2026-04

Locations

EG (1)