Abstract
The mid-sternum is the main source of pain after open cardiac surgery. The aim of this study was to investigate the effect of bilateral transversus thoracis muscle plane (TTMP) blocks on open cardiac surgery. Sixty patients were randomly divided into two groups: bilateral TTMP blocks (TP group) or no nerve block (CO group). The primary endpoint was perioperative sufentanil consumption. The secondary outcome measures included postoperative pain, flurbiprofen axetil administration, quality of sleep after extubation, time to extubation, time to the return of gastrointestinal function, time to drain removal, the Intensive Care Unit (ICU) stay time, and hospital stay. The TP group reported significantly less sufentanil and flurbiprofen axetil consumption than the CO group. The CO group had higher Numerical Rating Scale (NRS) pain scores at 1, 2, 6, 12, and 24 h after extubation both at rest and during movement than the TP groups. Compared with the CO group，time to extubation, time to the first bowel movement, ICU stay time, and hospital stay were significantly decreased in the TP group. The TP group was rated as better in the quality of the two nights of sleep after extubation. Bilateral TTMP blocks can provide good perioperative analgesia for patients undergoing open cardiac surgery and promote postoperative recovery.
Highlights
Postoperative pain is severe in patients undergoing cardiac surgery, especially from the median sternotomy incision 1,2
The time to extubation, time to the first flatus, length of stay in the Intensive Care Unit (ICU) and length of hospital stay were significantly decreased in the TP group compared with the CO groups (Table 2)
The present study demonstrated that the use of ultrasound-guided transversus thoracis muscle plane (TTMP) blocks could reduce the perioperative sufentanil consumption, dosage of postoperative flurbiprofen axetil, time to extubation, time to the first flatus, length of stay in the ICU and length of hospital stay in patients undergoing open cardiac surgery
Summary
Postoperative pain is severe in patients undergoing cardiac surgery, especially from the median sternotomy incision 1,2. According to a previous study, 705 patients undergoing open cardiac surgery suffer from pain, scoring between 5.3 and 6.5 out of 10 24 hours postoperatively 2. Poor postoperative analgesia in patients undergoing cardiac surgery increased morbidity and a longer hospital stay than patients without pain 3,4. High-dose opioids can provide good postoperative analgesia for patients undergoing heart surgery. The mid-sternum is the main source of pain after open cardiac surgery. The aim of this study was to investigate the effect of bilateral transversus thoracis muscle plane (TTMP) blocks on open cardiac surgery. Conclusion: Bilateral TTMP blocks can provide good perioperative analgesia for patients undergoing open cardiac surgery and promote postoperative recovery. Trial registration: This study was registered in the Chinese Clinical Trial Registry (ChiCTR2000032318) on 04/08/2019
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