Efficacy of Ultrasound-Guided Transversus Thoracic Muscle Plane Block on Postoperative Opioid Consumption After Cardiac Surgery: A Prospective, Randomized, Double-Blind Study

Aydın, Muhammed Enes; Ahıskalıoğlu, Ali; Ateş, İrem; Tor, Ibrahim Hakki; Borulu, Ferhat; Ergüney, Özlem Dilara; Çelik, Mine; Doğan, Nazım

doi:10.1053/j.jvca.2020.06.044

Cited by 71 publications

(63 citation statements)

References 21 publications

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“…Also, M.E. Aydin et al (14) & M. Cakmak and O. Isik (11) have found the same. On the other hand I.I.…”

Section: Discussionmentioning

confidence: 59%

“…Also, other studies reported the same. (9,14) We did not report any block-related complications. Also, in their studies, M.E.…”

Section: Discussionmentioning

confidence: 93%

“…Also, in their studies, M.E. Aydin et al (14) & Fujii et al (12) wrote no block-related complications. However, in a case series of 299 consecutive TTMP block cases, Ueshima H et al (15) said two patients with infection around the injection site.…”

Section: Discussionmentioning

confidence: 95%

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The Analgesic Efficacy of Ultrasound-guided Bilateral Transversus Thoracic MusclePlane Block after Open-Heart Surgeries: A Randomized Controlled Study

Hamed

Boules

Sobhy

et al. 2021

Preprint

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Background: We aimed to evaluate the analgesic efficacy of ultrasound-guided bilateral Transversus Thoracic Muscle Plane Block after Open-Heart Surgeries. Methods: 70 patients aged above 18 years and scheduled for valve replacement or adult congenital via median sternotomy were enrolled in this study. Patients were divided into two groups, randomized by computer-generated random numbers: the block group, which had the ultrasound-guided bilateral transversus thoracic muscle plane block, and the control group, which had a sham block. The primary outcome was total fentanyl consumption in the first 24-hours. The secondary outcomes were pain score, time to the first analgesic request, time to extubation , ICU stays, and hospital stay. Results: The total fentanyl consumption in the first 24 hours was significantly lower in the block group, with a mean difference of -158.286 (95% CI = (-179.271 to -137.300; p=<0.0001). The time to the first analgesic request was statistically significantly shorter in the non-block group (median 3 hours) than the block group (median 14 hours). During the postoperative period (0.5-24 hours), at-rest pain scores were 1.86 units lower in the block group (the estimate was -1.80, 95% CI = -2.14 to -1.45, t = -10.323 with p <0.0001). Likewise, pain scores with cough were 3.29 units lower in the block group (the estimate was -3.29, 95% CI = -3.80 to -2.77, t = -12.703, p <0.0001).Conclusion: Bilateral Transversus Thoracic Muscle Plane Block is a promising and effective technique in reducing opioid consumption and controlling post-sternotomy pain after open-heart surgery via median sternotomy.Trial Registration: This study is registered on ClinicalTrials.gov (NCT04116554; principal investigator: Mohamed Ahmed Hamed; date of registration: October 4, 2019).

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“…Also, M.E. Aydin et al (14) & M. Cakmak and O. Isik (11) have found the same. On the other hand I.I.…”

Section: Discussionmentioning

confidence: 59%

“…Also, other studies reported the same. (9,14) We did not report any block-related complications. Also, in their studies, M.E.…”

Section: Discussionmentioning

confidence: 93%

See 1 more Smart Citation

The Analgesic Efficacy of Ultrasound-guided Bilateral Transversus Thoracic MusclePlane Block after Open-Heart Surgeries: A Randomized Controlled Study

Hamed

Boules

Sobhy

et al. 2021

Preprint

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“…Özellikle her gün bir yenisi tanımlanan plan blokları ile anestezistlerin bölgesel yapılara sonoanatomik egemenliği artmaktadır. Poststernotomi ağrısı için analjezi amacıyla uyguladığımız transversus torasik kas plan bloğu deneyimlerimiz sırasında bu kas planına enjekte edilen lokal anesteziğin LIMA etrafında hidrodiseksiyon oluşturarak bir depozit meydana getirdiğini fark ettik [6] . Bu deneyim ile transversus torasik kas planına lokal anestezik yerine papaverin enjekte ederek LIMA serbestleştirilmesi işlemi öncesinde bir spazm önleyici etki sağlayabileceğimiz hipotezi üzerine çalışmamızı tasarladık.…”

Section: Introductionunclassified

Ultrasound-Guided Transverse Thoracic Muscle Plane Injection vs. Topical Spraying of Papaverine for LIMA Harvesting: A Pilot Study

Aydın¹,

Al²,

Yayık³

et al. 2021

GKDA Derg

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INTRODUCTION: Although the effect of topical papaverine on the left internal mammary artery (LIMA) flow is a well-known method, papaverine hydro dissection is applied to the transverse thoracic muscle plane is unknown. This study aims to investigate the effect of ultrasound-guided transverse thoracic muscle plane papaverine injection on LIMA flow. METHODS: ASA II-III, 40 patients who underwent coronary artery bypass grafting surgery, were randomly divided into two groups. Group topical papaverine (Group TP, n=20) and Group ultrasound-guided papaverine (Group USP, n=20). In Group TP, 10 mg papaverine in 10 mL saline was administered topically after LIMA harvesting. In Group USP, ultrasound-guided transverse thoracic muscle plane papaverine injection with the same solution preoperatively. Trans-time flow measurements (TTFM), LIMA harvesting time, and surgeon satisfaction were recorded. RESULTS: There was no difference in LIMA free flows before anastomosis between Group USP and Group TP (111.35±69.76 vs. 92.15±46.76, respectively, p=0.185). There was no significant difference between the groups in TTFM values evaluated after anastomosis (p> 0.05). LIMA harvesting time was statistically shorter in Group USP than Group TP (13.90±3.01 vs. 16.65±4.50 respectively, p=0.049). Surgeon LIMA harvest satisfaction was statistically significantly higher in group USP (p=0.029). DISCUSSION AND CONCLUSION: We think that papaverine injection via ultrasound-guided transverse thoracic muscle plane may be an alternative method to topical application to prevent LIMA spasm.

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“…IN THIS EDITION of the Journal, Aydin et al 1 reported an investigation of the efficacy of the transversus thoracic muscle plane block (TTMPB) in cardiac surgery. This is one of a deluge of new fascial plane blocks that may have some application to analgesia after cardiac surgery.…”

mentioning

confidence: 99%

Fascial Plane Blocks: The Rise of the “Good- Enough” Block

Byrne

Cutts

2020

Journal of Cardiothoracic and Vascular Anesthesia

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Efficacy of Ultrasound-Guided Transversus Thoracic Muscle Plane Block on Postoperative Opioid Consumption After Cardiac Surgery: A Prospective, Randomized, Double-Blind Study

Cited by 71 publications

References 21 publications

The Analgesic Efficacy of Ultrasound-guided Bilateral Transversus Thoracic MusclePlane Block after Open-Heart Surgeries: A Randomized Controlled Study

The Analgesic Efficacy of Ultrasound-guided Bilateral Transversus Thoracic MusclePlane Block after Open-Heart Surgeries: A Randomized Controlled Study

Ultrasound-Guided Transverse Thoracic Muscle Plane Injection vs. Topical Spraying of Papaverine for LIMA Harvesting: A Pilot Study

Fascial Plane Blocks: The Rise of the “Good- Enough” Block

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