AzTrials
AzTrials

Cardiac SurgeryNCT04928521

Erector Spinae Plane (ESP) Block With 20 ml Versus 30 ml in Cardiac Surgery

A study testing bilateral erector spinae plane block with 30 mL 0.25 % bupivacaine and bilateral erector spinae plane block with 20 mL 0.25 % bupivacaine in people with Cardiac Surgery and Postoperative Pain, run by Ankara City Hospital Bilkent at 1 site in Turkey (Türkiye).

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
Search all trials

Trial summary

Even though erector spinae plane (ESP) block is shown to be efficient in cardiac surgery, it is still controversial how much volume is necessary for efficient analgesic effect for sternotomy and drain tube pain relief. Read more about this study

Who is it for?
Ages 18 to 65 years
Conditions the study is for
Cardiac Surgery, Postoperative Pain
What is being tested?
bilateral erector spinae plane block with 30 mL 0.25 % bupivacaine and bilateral erector spinae plane block with 20 mL 0.25 % bupivacaine
Type of treatment
Surgery or procedure
Could I receive a placebo?
No, everyone receives an active treatment
How many people
70 participants
Where
1 siteTurkey (Türkiye)
Study dates
1 Jun 2021to 1 Oct 2021
Phase
Interventional
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 65 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Adult patients who will undergo coronary artery bypass grafting surgery with median sternotomy

Who cannot join

  • Emergency surgeries
  • Patients with allergic reactions to anesthesia and analgesia drugs to be used
  • Patients who do not want to participate in the study voluntarily
  • Severe systemic disease (kidney, liver, pulmonary, endocrine)
  • Substance abuse history
  • History of chronic pain
Show all 9Show fewer
  • Psychiatric problems and communication difficulties
  • Patients who need revision due to hemostasis in the postoperative period
  • Patients with severe hemodynamic instability due to infection, heavy bleeding, etc.

Trial locations and contacts

1 site in 1 country.

Turkey (Türkiye)1 site
  • Ankara City Hospital

    Ankara, Select State/Province, 06800

Other trials in Turkey (Türkiye)

About this study

Official title: Comparison of Postoperative Analgesic Efficacy of Erector Spinae Plane Block With 20 ml and 30 ml Bupivacaine Volumes in Cardiac Surgery

Even though erector spinae plane (ESP) block is shown to be efficient in cardiac surgery, it is still controversial how much volume is necessary for efficient analgesic effect for sternotomy and drain tube pain relief. This study aims to investigate the optimal local anesthetic volume (20 mL versus 30 mL) with ESP block for open-heart cardiac surgery.

Read the detailed description

In cardiac surgery, the most common cause of pain during the first two days postoperatively is median sternotomy. In a study in which 705 patients who had undergone cardiac surgery were followed up prospectively, postoperative 24 hours pain scores ranging from 5.3 to 6.5 out of 10 with deep breathing and coughing were shown. In these patients, it may increase the frequency of atelectasis due to reasons such as failure in pain control, weak coughing, and limitation of movement, and these may lead increase in morbidity and hospital stay. Although nonsteroidal analgesics and opioids are used successfully in the control of this severe pain, they are far from being ideal analgesics alone due to their side effects such as kidney damage, bleeding risk, sedation, respiratory depression, itching, nausea, and vomiting. The complications of neuraxial techniques seem to be the disadvantages of these methods. Erector spinae plane (ESP) block is one of the regional anesthesia techniques that has been shown to be effective in reducing sternotomy pain in sternotomy-guided cardiac surgeries.

The Erector spinae plane (ESP) block was first described by Forero in 2016. In this block technique, a local anesthetic is given to the plane between the erector spinae muscle and the vertebral transverse process. The dorsal and ventral branches of the spinal nerves are blocked in this plane. However, due to individual regional anatomical differences, there is not enough data to determine the optimum volume at which the appropriate spread of local anesthetic will occur. Volume-based cadaver studies have some handicaps since they do not have the characteristics of living tissue.

This study aims to compare the postoperative analgesic efficacy of ESP block applied at the same dose but with different local anesthetic volumes in cardiac surgeries to be performed with sternotomy.

Being tested
bilateral erector spinae plane block with 30 mL 0.25 % bupivacaine, bilateral erector spinae plane block with 20 mL 0.25 % bupivacaine
Keywords
erector spinae plane block, local anesthetic volume, bupivacaine, sternotomy
Medical subject headings
Pain, Postoperative

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • bilateral erector spinae plane block with 30 mL 0.25 % bupivacaineProcedure or surgery

    Also called 30 mL

    Preoperative, awake, bilateral, ultrasound-guided erector spinae plane block with 30 mL 0.25 % bupivacaine

  • bilateral erector spinae plane block with 20 mL 0.25 % bupivacaineProcedure or surgery

    Also called 20 mL

    Preoperative, awake, bilateral, ultrasound-guided erector spinae plane block with 20 mL 0.25 % bupivacaine

Study groups in NCT04928521
Study groupRoleWhat they receive
ESP block with 20 mL local anesthetic solutionActive comparatorAn erector spinae plane block will be performed at the level of the 5th thoracic vertebrae with 20 mL of 0.25% bupivacaine solution under ultrasound guidance before the operation.
Receives: Procedure: bilateral erector spinae plane block with 20 mL 0.25 % bupivacaine
ESP block with 30 mL local anesthetic solutionActive comparatorAn erector spinae plane block will be performed at the level of the 5th thoracic vertebrae with 30 mL of 0.25% bupivacaine solution under ultrasound guidance before the operation.
Receives: Procedure: bilateral erector spinae plane block with 30 mL 0.25 % bupivacaine

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Post-extubation 1st hour measurement

    patients will be evaluated in terms of the visual analog pain scale, the scale has a range of 0 to 10. The scale will be shown to patients and 0 means the patient has no pain, 10 means the patient feels the most pain ever felt.

    Measured: 1 hour after endotracheal extubation, an average of 5 minutes

  2. Post-extubation 1st hour measurement

    patients will be evaluated in terms of nausea and vomiting, if they have nausea or vomiting it will be recorded as nausea positive or vomiting positive, otherwise it will be recorded as negative.

    Measured: 1 hour after endotracheal extubation, an average of 5 minutes

  3. Post-extubation 1st hour measurement

    patients will be evaluated in terms of rescue analgesic, when patients have more than 4 visual analog score (VAS), they will be administered 1mg/kg tramadol and it will be recorded.

    Measured: 1 hour after endotracheal extubation, an average of 5 minutes

  4. Post-extubation 2nd hour measurement

    patients will be evaluated in terms of the visual analog pain scale, the scale has a range of 0 to 10. The scale will be shown to patients and 0 means the patient has no pain, 10 means the patient feels the most pain ever felt.

    Measured: 2 hour after endotracheal extubation, an average of 5 minutes

  5. Post-extubation 2nd hour measurement

    patients will be evaluated in terms of nausea and vomiting, if they have nausea or vomiting it will be recorded as nausea positive or vomiting positive, otherwise it will be recorded as negative.

    Measured: 2 hour after endotracheal extubation, an average of 5 minutes

  6. Post-extubation 2nd hour measurement

    patients will be evaluated in terms of rescue analgesic, when patients have more than 4 visual analog score (VAS), they will be administered 1mg/kg tramadol and it will be recorded.

    Measured: 2 hour after endotracheal extubation, an average of 5 minutes

  7. Post-extubation 4th hour measurement

    patients will be evaluated in terms of the visual analog pain scale, the scale has a range of 0 to 10. The scale will be shown to patients and 0 means the patient has no pain, 10 means the patient feels the most pain ever felt.

    Measured: 4 hour after endotracheal extubation, an average of 5 minutes

  8. Post-extubation 4th hour measurement

    patients will be evaluated in terms of nausea and vomiting, if they have nausea or vomiting it will be recorded as nausea positive or vomiting positive, otherwise it will be recorded as negative.

    Measured: 4 hour after endotracheal extubation, an average of 5 minutes

  9. Post-extubation 4th hour measurement

    patients will be evaluated in terms of rescue analgesic, when patients have more than 4 visual analog score (VAS), they will be administered 1mg/kg tramadol and it will be recorded.

    Measured: 4 hour after endotracheal extubation, an average of 5 minutes

  10. Post-extubation 8th hour measurement

    patients will be evaluated in terms of the visual analog pain scale, the scale has a range of 0 to 10. The scale will be shown to patients and 0 means the patient has no pain, 10 means the patient feels the most pain ever felt.

    Measured: 8 hour after endotracheal extubation, an average of 5 minutes

  11. Post-extubation 8th hour measurement

    patients will be evaluated in terms of nausea and vomiting, if they have nausea or vomiting it will be recorded as nausea positive or vomiting positive, otherwise it will be recorded as negative.

    Measured: 8 hour after endotracheal extubation, an average of 5 minutes

  12. Post-extubation 8th hour measurement

    patients will be evaluated in terms of rescue analgesic, when patients have more than 4 visual analog score (VAS), they will be administered 1mg/kg tramadol and it will be recorded.

    Measured: 8 hour after endotracheal extubation, an average of 5 minutes

  13. Post-extubation 12th hour measurement

    patients will be evaluated in terms of the visual analog pain scale, the scale has a range of 0 to 10. The scale will be shown to patients and 0 means the patient has no pain, 10 means the patient feels the most pain ever felt.

    Measured: 12 hour after endotracheal extubation, an average of 5 minutes

  14. Post-extubation 12th hour measurement

    patients will be evaluated in terms of nausea and vomiting, if they have nausea or vomiting it will be recorded as nausea positive or vomiting positive, otherwise it will be recorded as negative.

    Measured: 12 hour after endotracheal extubation, an average of 5 minutes

  15. Post-extubation 12th hour measurement

    patients will be evaluated in terms of rescue analgesic, when patients have more than 4 visual analog score (VAS), they will be administered 1mg/kg tramadol and it will be recorded.

    Measured: 12 hour after endotracheal extubation, an average of 5 minutes

  16. Post-extubation 24th hour measurement

    patients will be evaluated in terms of the visual analog pain scale, the scale has a range of 0 to 10. The scale will be shown to patients and 0 means the patient has no pain, 10 means the patient feels the most pain ever felt.

    Measured: 24 hour after endotracheal extubation, an average of 5 minutes

  17. Post-extubation 24th hour measurement

    patients will be evaluated in terms of nausea and vomiting, if they have nausea or vomiting it will be recorded as nausea positive or vomiting positive, otherwise it will be recorded as negative.

    Measured: 24 hour after endotracheal extubation, an average of 5 minutes

  18. Post-extubation 24th hour measurement

    patients will be evaluated in terms of rescue analgesic, when patients have more than 4 visual analog score (VAS), they will be administered 1mg/kg tramadol and it will be recorded.

    Measured: 24 hour after endotracheal extubation, an average of 5 minutes

Secondary outcomes (2)
  1. Mechanical ventilation duration

    The total time until patients suitable for endotracheal extubation

    Measured: postoperative, approximately 4 to 10 hours

  2. intensive care unit duration

    The total time until patients suitable for discharge from intensive care unit

    Measured: postoperative, approximately 12 to 36 hours

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted16 Jun 2021
  2. Study start1 Jun 2021
  3. Primary completion1 Aug 2021
  4. Study completion1 Oct 2021

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Supportive care
Allocation
Randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
70 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04928521
Sponsor's protocol ID
MH2.3
Status last verified
Dec 2021
First submitted
6 Jun 2021
Last updated
28 Dec 2021
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No

Publications

  • Mueller XM, Tinguely F, Tevaearai HT, Revelly JP, Chiolero R, von Segesser LK. Pain location, distribution, and intensity after cardiac surgery. Chest. 2000 Aug;118(2):391-6. doi: 10.1378/chest.118.2.391.

    PubMed 10936130
  • Milgrom LB, Brooks JA, Qi R, Bunnell K, Wuestfeld S, Beckman D. Pain levels experienced with activities after cardiac surgery. Am J Crit Care. 2004 Mar;13(2):116-25.

    PubMed 15043239
  • Cheng DC, Wall C, Djaiani G, Peragallo RA, Carroll J, Li C, Naylor D. Randomized assessment of resource use in fast-track cardiac surgery 1-year after hospital discharge. Anesthesiology. 2003 Mar;98(3):651-7. doi: 10.1097/00000542-200303000-00013.

    PubMed 12606909
  • Silbert BS, Santamaria JD, Kelly WJ, O'brien JL, Blyth CM, Wong MY, Allen NB; Fast Track Cardiac Care Team. Early extubation after cardiac surgery: emotional status in the early postoperative period. J Cardiothorac Vasc Anesth. 2001 Aug;15(4):439-44. doi: 10.1053/jcan.2001.24978.

    PubMed 11505346
  • Forero M, Adhikary SD, Lopez H, Tsui C, Chin KJ. The Erector Spinae Plane Block: A Novel Analgesic Technique in Thoracic Neuropathic Pain. Reg Anesth Pain Med. 2016 Sep-Oct;41(5):621-7. doi: 10.1097/AAP.0000000000000451.

    PubMed 27501016

Questions about this trial

What is this clinical trial studying?

A study testing bilateral erector spinae plane block with 30 mL 0.25 % bupivacaine and bilateral erector spinae plane block with 20 mL 0.25 % bupivacaine in people with Cardiac Surgery and Postoperative Pain, run by Ankara City Hospital Bilkent at 1 site in Turkey (Türkiye).

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 1 inclusion and 9 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 28 Dec 2021. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Turkey (Türkiye). Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Post-extubation 1st hour measurement (time frame: 1 hour after endotracheal extubation, an average of 5 minutes). The study lists 18 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT04928521, which also lists 5 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 28 Dec 2021; AzTrials last refreshed its copy on 1 Nov 2026.

Free account

Log in to keep searching

You’ve used your 3 free searches. AzTrials is free: log in or create a free account to keep searching clinical trials and save the ones you want to follow.

Create a free accountLog in