RecruitingNot ApplicableNCT05885230

Efficacy of Ultrasound Guided PIFB Versus Lidocaine Infusion on Postoperative Pain After Thoracotomy

The Efficacy of Ultrasound-guided Pecto-Intercostal Fascial Plain Block Versus Lidocaine Infusion on Acute and Chronic Post-thoracotomy Pain; A Prospective Randomized Controlled Trial

Sponsor

Beni-Suef University

Enrollment

138 participants

Start Date

May 1, 2023

Study Type

INTERVENTIONAL

Conditions

Cardiac Surgery

Summary

Chronic pain is a common complication after cardiothoracic surgery. The prevalence of post-thoracotomy pain syndrome (PTPS) ranges from 33% to 91%. Exact pathogenetic mechanisms for developing chronic pain after thoracotomy are unknown. Apart from intraoperative nerve damage and subsequent postoperative neuropathic pain, operation techniques, age, sex, pre-existing pain, genetic and psychosocial factors, severe postoperative pain, and analgesic management are suspected to have an impact on the development of PTPS .

Eligibility

Min Age: 18 YearsMax Age: 75 Years

Inclusion Criteria3

age between 18 and 75 years.
patient scheduled to undergo elective on-pump cardiac surgery with sternotomy.
American Society of Anesthesiologists classification of physical status < IV.

Exclusion Criteria13

emergency surgery.
off-pump surgery.
redo surgery.
ejection fraction less than 35%.
refusal of the patient.
known hypersensitivity to LA.
chronic opioid use or chronic pain patient.
psychiatric problems or communication difficulties.
liver insufficiency (defined as a serum bilirubin ≥ 34 μmol/l, albumin ≤ 35 g/dl, INR ≥ 1.7).
renal insufficiency (defined as a glomerular filtration rate < 44 ml/min).
obstructive sleep apnea syndrom.
coexisting hematologic disorders.
pregnancy or breastfeeding.

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Interventions

PROCEDUREpecto intercostal fascial block using bupivacaine 0.25%

patients will receive bilateral ultrasound-guided pecto-intercostal fascial block using 20 ml of bupivacaine 0.25% for each side.

DRUGlidocaine infusion

1.5 mg/kg lidocaine will be administered after induction of anesthesia, then 2mg/kg/h lidocaine will be administered with continuous intravenous infusion until the end of the surgery.