Comparing a single erector spinae block to parasternal plus serratus blocks for pain after sternotomy
Sternotomi İle Kardiyak Cerrahi Planlanan Hastalarda Postoperatif Sternotomi Ağrısının Yönetiminde Erektör Spina Plan Blok (ESPB) Ile Yüzeyel Parasternal İnterkostal Plan Bloğu (SPIPB) ve Serratus Anterior Plan Bloğu (SAPB) Kombinasyonunun Karşılaştırılması
We will see if a single erector spinae nerve block or a combination of superficial parasternal and serratus anterior blocks better controls pain and reduces opioid use in adults having elective open‑chest (sternotomy) heart surgery.
Quick facts
| Phase | Not applicable |
|---|---|
| Study type | Interventional |
| Enrollment | 50 (estimated) |
| Ages | 18 Years to 80 Years |
| Sex | All |
| Sponsor | Uludag University Academic / other |
| Locations | 1 site (Bursa, Nilüfer) |
| Trial ID | NCT07472296 on ClinicalTrials.gov |
What this trial studies
This randomized interventional study will enroll 50 adults (ages 18–80, ASA I–III) scheduled for elective cardiac surgery via median sternotomy and assign them before anesthesia to either an erector spinae plane block (ESPB) or a combined superficial parasternal intercostal plane block (SPIPB) plus serratus anterior plane block (SAPB). Nerve blocks are performed prior to induction of general anesthesia and standard intraoperative and postoperative care follows. Outcomes include pain scores at rest and with coughing (VAS), intraoperative opioid use, behavioral pain scores after surgery, extubation times, and time to first rescue analgesic. The protocol compares analgesic efficacy and opioid-sparing effects between the two regional anesthesia approaches.
Who should consider this trial
Good fit: Adults aged 18–80 with ASA physical status I–III who are scheduled for elective cardiac surgery via median sternotomy and can give informed consent are ideal candidates.
Not a fit: Patients having emergency or redo cardiac surgery, with BMI over 35, coagulopathy, infection at the injection site, allergy to local anesthetics, or severe organ failure are unlikely to be eligible or to benefit from this protocol.
Why it matters
Potential benefit: If successful, the better block strategy could reduce postoperative sternotomy pain, lower opioid requirements, and speed early recovery after cardiac surgery.
How similar studies have performed: Related regional blocks such as ESPB, SAPB, and parasternal blocks have shown promise in reducing thoracic and poststernotomy pain and opioid use, but direct head‑to‑head comparisons of ESPB versus the combined SPIPB+SAPB approach are limited.
Eligibility criteria
Show full inclusion / exclusion criteria
Inclusion Criteria: * Patients aged between 18 and 80 years. * Patients classified as American Society of Anesthesiologists (ASA) physical status I, II, or III. * Patients scheduled for elective cardiac surgery via median sternotomy. * Patients who have provided written informed consent. Exclusion Criteria: * Pregnancy or suspected pregnancy. * Body Mass Index (BMI) \> 35 kg/m². * Known allergy or hypersensitivity to local anesthetics (e.g., bupivacaine). * Suspected coagulopathy or bleeding disorders. * Infection at the site of the regional block injection. * Severe hepatic or renal failure. * Severe neurological or psychiatric disorders. * Emergency surgical procedures. * Re-operation cases (Redo-surgery)
Where this trial is running
Bursa, Nilüfer
- Bursa Uludag University Hospital — Bursa, Nilüfer, Turkey (Türkiye) (Recruiting)
How to participate
- Review the eligibility criteria above with your treating physician.
- Visit the official trial page on ClinicalTrials.gov for the most current contact information and recruitment status.
- Contact the listed study coordinator or principal investigator to request pre-screening. Pre-screening is free and never obligates you to enroll.