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Ultrasound Guided Parasternal Block for Perioperative Analgesia in Cardiac Surgery: A Prospective Study
Ultrasound guided parasternal block is a regional anaesthesia technique targeting the anterior branches of intercostal nerves, which supply the anterior thoracic wall. The aim of this prospective study is to assess the efficacy of parasternal block to manage postoperative analgesia and reduce opioid...
Autores principales: | , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10003888/ https://www.ncbi.nlm.nih.gov/pubmed/36902846 http://dx.doi.org/10.3390/jcm12052060 |
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author | Pascarella, Giuseppe Costa, Fabio Nonnis, Giulia Strumia, Alessandro Sarubbi, Domenico Schiavoni, Lorenzo Di Pumpo, Annalaura Mortini, Lara Grande, Stefania Attanasio, Andrea Gadotti, Giovanni De Cassai, Alessandro Mattei, Alessia Nenna, Antonio Chello, Massimo Cataldo, Rita Agrò, Felice Eugenio Carassiti, Massimiliano |
author_facet | Pascarella, Giuseppe Costa, Fabio Nonnis, Giulia Strumia, Alessandro Sarubbi, Domenico Schiavoni, Lorenzo Di Pumpo, Annalaura Mortini, Lara Grande, Stefania Attanasio, Andrea Gadotti, Giovanni De Cassai, Alessandro Mattei, Alessia Nenna, Antonio Chello, Massimo Cataldo, Rita Agrò, Felice Eugenio Carassiti, Massimiliano |
author_sort | Pascarella, Giuseppe |
collection | PubMed |
description | Ultrasound guided parasternal block is a regional anaesthesia technique targeting the anterior branches of intercostal nerves, which supply the anterior thoracic wall. The aim of this prospective study is to assess the efficacy of parasternal block to manage postoperative analgesia and reduce opioid consumption in patients undergoing cardiac surgery throughout sternotomy. A total of 126 consecutive patients were allocated to two different groups, receiving (Parasternal group) or not (Control group) preoperative ultrasound guided bilateral parasternal block with 20 mL of 0.5% ropivacaine per side. The following data were recorded: postoperative pain expressed by a 0–10 numeric rating scale (NRS), intraoperative fentanyl consumption, postoperative morphine consumption, time to extubation and perioperative pulmonary performance at incentive spirometry. Postoperative NRS was not significantly different between Parasternal and Control groups with a median (IQR) of 2 (0–4.5) vs. 3 (0–6) upon awakening (p = 0.07); 0 (0–3) vs. 2 (0–4) at 6 h (p = 0.46); 0 (0–2) vs. 0 (0–2) at 12 h (p = 0.57). Postoperative morphine consumption was similar among groups. However, intraoperative fentanyl consumption was significantly lower in the Parasternal group [406.3 ± 81.6 mcg vs. 864.3 ± 154.4, (p < 0.001)]. Parasternal group showed shorter times to extubation [(191 ± 58 min vs. 305 ± 72 min, (p)] and better performance at incentive spirometer with a median (IQR) of 2 raised balls (1–2) vs. 1 (1–2) after awakening (p = 0.04). Ultrasound guided parasternal block provided an optimal perioperative analgesia with a significant reduction in intraoperative opioid consumption, time to extubation and a better postoperative performance at spirometry when compared to the Control group. |
format | Online Article Text |
id | pubmed-10003888 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-100038882023-03-11 Ultrasound Guided Parasternal Block for Perioperative Analgesia in Cardiac Surgery: A Prospective Study Pascarella, Giuseppe Costa, Fabio Nonnis, Giulia Strumia, Alessandro Sarubbi, Domenico Schiavoni, Lorenzo Di Pumpo, Annalaura Mortini, Lara Grande, Stefania Attanasio, Andrea Gadotti, Giovanni De Cassai, Alessandro Mattei, Alessia Nenna, Antonio Chello, Massimo Cataldo, Rita Agrò, Felice Eugenio Carassiti, Massimiliano J Clin Med Article Ultrasound guided parasternal block is a regional anaesthesia technique targeting the anterior branches of intercostal nerves, which supply the anterior thoracic wall. The aim of this prospective study is to assess the efficacy of parasternal block to manage postoperative analgesia and reduce opioid consumption in patients undergoing cardiac surgery throughout sternotomy. A total of 126 consecutive patients were allocated to two different groups, receiving (Parasternal group) or not (Control group) preoperative ultrasound guided bilateral parasternal block with 20 mL of 0.5% ropivacaine per side. The following data were recorded: postoperative pain expressed by a 0–10 numeric rating scale (NRS), intraoperative fentanyl consumption, postoperative morphine consumption, time to extubation and perioperative pulmonary performance at incentive spirometry. Postoperative NRS was not significantly different between Parasternal and Control groups with a median (IQR) of 2 (0–4.5) vs. 3 (0–6) upon awakening (p = 0.07); 0 (0–3) vs. 2 (0–4) at 6 h (p = 0.46); 0 (0–2) vs. 0 (0–2) at 12 h (p = 0.57). Postoperative morphine consumption was similar among groups. However, intraoperative fentanyl consumption was significantly lower in the Parasternal group [406.3 ± 81.6 mcg vs. 864.3 ± 154.4, (p < 0.001)]. Parasternal group showed shorter times to extubation [(191 ± 58 min vs. 305 ± 72 min, (p)] and better performance at incentive spirometer with a median (IQR) of 2 raised balls (1–2) vs. 1 (1–2) after awakening (p = 0.04). Ultrasound guided parasternal block provided an optimal perioperative analgesia with a significant reduction in intraoperative opioid consumption, time to extubation and a better postoperative performance at spirometry when compared to the Control group. MDPI 2023-03-06 /pmc/articles/PMC10003888/ /pubmed/36902846 http://dx.doi.org/10.3390/jcm12052060 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Pascarella, Giuseppe Costa, Fabio Nonnis, Giulia Strumia, Alessandro Sarubbi, Domenico Schiavoni, Lorenzo Di Pumpo, Annalaura Mortini, Lara Grande, Stefania Attanasio, Andrea Gadotti, Giovanni De Cassai, Alessandro Mattei, Alessia Nenna, Antonio Chello, Massimo Cataldo, Rita Agrò, Felice Eugenio Carassiti, Massimiliano Ultrasound Guided Parasternal Block for Perioperative Analgesia in Cardiac Surgery: A Prospective Study |
title | Ultrasound Guided Parasternal Block for Perioperative Analgesia in Cardiac Surgery: A Prospective Study |
title_full | Ultrasound Guided Parasternal Block for Perioperative Analgesia in Cardiac Surgery: A Prospective Study |
title_fullStr | Ultrasound Guided Parasternal Block for Perioperative Analgesia in Cardiac Surgery: A Prospective Study |
title_full_unstemmed | Ultrasound Guided Parasternal Block for Perioperative Analgesia in Cardiac Surgery: A Prospective Study |
title_short | Ultrasound Guided Parasternal Block for Perioperative Analgesia in Cardiac Surgery: A Prospective Study |
title_sort | ultrasound guided parasternal block for perioperative analgesia in cardiac surgery: a prospective study |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10003888/ https://www.ncbi.nlm.nih.gov/pubmed/36902846 http://dx.doi.org/10.3390/jcm12052060 |
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