Comparing two chest-wall nerve blocks (TTPB vs PIFB) to reduce pain after open-heart bypass surgery
Transversus Thoracic Muscle Plane Block Versus Pectointercostal Fascial Block for Enhanced Recovery After Cardiac Surgery: A Randomized Controlled Trial
This will test whether two ultrasound-guided chest-wall nerve blocks (transversus thoracic muscle plane block or pectointercostal fascial block) reduce pain and speed recovery for adults aged 40–60 having open-heart bypass surgery.
Quick facts
| Phase | Not applicable |
|---|---|
| Study type | Interventional |
| Enrollment | 90 (estimated) |
| Ages | 40 Years to 60 Years |
| Sex | All |
| Sponsor | Assiut University Academic / other |
| Locations | 1 site (Asyut) |
| Trial ID | NCT07417462 on ClinicalTrials.gov |
What this trial studies
Post-sternotomy pain is often severe in the first 24 hours and can slow recovery after open cardiac procedures. This study compares two ultrasound-guided regional anesthesia techniques, the transversus thoracic muscle plane block (TTPB) and the pectointercostal fascial block (PIFB), against a sham control in patients undergoing coronary artery bypass grafting with median sternotomy. Both blocks target the anterior cutaneous branches of the intercostal nerves (T2–T6) to provide analgesia to the parasternal and medial anterior chest wall, and the study will record pain scores, opioid consumption, and recovery measures after surgery. Eligible patients receive perioperative ultrasound-guided blocks and are followed through the immediate postoperative period to compare analgesic efficacy and enhanced recovery outcomes.
Who should consider this trial
Good fit: Ideal candidates are adults 40–60 years old with BMI under 35, ASA physical status II–III, left ventricular ejection fraction ≥30%, scheduled for elective coronary artery bypass grafting via median sternotomy.
Not a fit: Patients undergoing valve replacement, emergency or redo operations, minimally invasive approaches, those with severe organ dysfunction, LVEF below 30%, known allergy to local anesthetics, cognitive impairment, or who are pregnant or breastfeeding are unlikely to be eligible or to receive benefit from these blocks.
Why it matters
Potential benefit: If successful, these nerve blocks could reduce sternotomy pain, lower opioid use, and help patients recover faster after bypass surgery.
How similar studies have performed: These blocks are relatively new but early case series and small randomized studies have suggested they can reduce postoperative chest pain and opioid use, though larger definitive trials are limited.
Eligibility criteria
Show full inclusion / exclusion criteria
Inclusion Criteria: * Age from 40 to 60 years. * Both sexes. * American Society of Anesthesiology (ASA) physical status II-III. * Body mass index (BMI) \< 35 kg/m2. * Underwent cardiac surgery (coronary artery bypass graft surgery with median sternotomy). Exclusion Criteria: * Valve replacement procedures. * Emergency operations. * Redo surgeries. * Minimally invasive approaches. * The presence of psychiatric disorders. * Cognitive impairment preventing accurate assessment using the verbal numerical rating scale (NRS). * Known hypersensitivity or a history of allergy to local anesthetics. * Had severe major organ dysfunction. * Left ventricular ejection fraction below 30%. * Pregnancy or breastfeeding.
Where this trial is running
Asyut
- Assiut University — Asyut, Egypt (Recruiting)
Study contacts
- Study coordinator: Noha H Abdelghany, MD
- Email: nohadaghash@gmail.com
- Phone: +966545945924
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.