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

Last updated: April 8, 2024
Sponsor: Beni-Suef University
Overall Status: Active - Recruiting

Phase

N/A

Condition

Cardiac Surgery

Treatment

lidocaine infusion

pecto intercostal fascial block using bupivacaine 0.25%

Clinical Study ID

NCT05885230
FMBSUREC/09042023/Mikhael
  • Ages 18-75
  • All Genders
  • Accepts Healthy Volunteers

Study 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 Criteria

Inclusion

Inclusion Criteria:

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

Exclusion

Exclusion Criteria:

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

Study Design

Total Participants: 138
Treatment Group(s): 2
Primary Treatment: lidocaine infusion
Phase:
Study Start date:
May 01, 2023
Estimated Completion Date:
May 31, 2024

Study Description

Ultrasound-guided Pecto-intercostal Fascial Block (PIFB) has been advocated by some researchers for cardiac surgery. Pecto-intercostal fascial plane block (PIFB) is a novel, minimally invasive, regional fascial plane block technique. PIFB was first described by de la Torre in patients undergoing breast surgery . PIFB targets the anterior intercostal nerves as they run in the fascial plane between the pectoral and the intercostal muscles and emerge on either side of the sternum.

Also, lidocaine, a short-acting local anesthetic, has been proved to have analgesic and anti-inflammatory effects . The application of lidocaine by continuous infusion in the intraoperative period and immediately after the surgery appears to reduce the immediate postoperative pain, and may prevent the PTPS

Connect with a study center

  • Benisuef University Hospital

    Banī Suwayf, e\EYGPT
    Egypt

    Active - Recruiting

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