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Parasternal Intercostal Nerve Block and Chronic Pain After Cardiac Surgery
Sponsor: Bakirkoy Dr. Sadi Konuk Research and Training Hospital
Summary
Chronic post-sternotomy pain is a common but under-recognised complication of cardiac surgery, reported in roughly 11 to 56 percent of patients and capable of persisting for years after the operation. Effective control of pain in the early postoperative period is thought to reduce the central sensitisation that drives the transition from acute to chronic pain. This single-centre, prospective, randomised, patient- and assessor-blinded controlled trial investigates whether an ultrasound-guided bilateral parasternal intercostal nerve block, performed preemptively after induction of general anaesthesia and before surgical incision, reduces the incidence of chronic pain three months after cardiac surgery performed through a median sternotomy. A total of 132 adults scheduled for elective cardiac surgery will be randomised in a 1:1 ratio to receive either the block plus the institution's standard multimodal analgesia protocol, or the standard protocol alone. The primary endpoint is the incidence of chronic post-sternotomy pain at three months, assessed with the Turkish version of the Brief Pain Inventory - Short Form. Secondary endpoints cover acute pain scores, opioid consumption, postoperative nausea and vomiting, and complications.
Official title: Effect of Ultrasound-Guided Preemptive Parasternal Intercostal Nerve Block on the Incidence of Chronic Pain After Cardiac Surgery Via Sternotomy: A Prospective Randomized Controlled Trial
Key Details
Gender
All
Age Range
18 Months - 75 Years
Study Type
INTERVENTIONAL
Enrollment
132
Start Date
2026-08-25
Completion Date
2028-08-25
Last Updated
2026-09-14
Healthy Volunteers
No
Interventions
Ultrasound-Guided Parasternal Intercostal Nerve Block
Performed in the supine position after induction of general anaesthesia and before surgical incision, using a 6-15 MHz linear ultrasound probe and a 22 G, 80 mm echogenic block needle.
Bupivacaine 0.25%
0.25 percent bupivacaine administered bilaterally as a single preemptive dose for the parasternal intercostal nerve block.