{"title":"Bilateral parasternal and rectus sheath blocks reduce pain post-cardiac surgery: a pilot trial.","authors":"Yangsi Huang, Chengdi Ouyang, Fang He, Yu Zhong, Guofeng Liu, Yizhi Lu, Yanhua Chen","doi":"10.3389/fsurg.2025.1526890","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to investigate the effects of ultrasound-guided bilateral parasternal block (PSB) combined with rectus sheath block (RSB) on postoperative recovery quality in patients undergoing median sternotomy for cardiac surgery.</p><p><strong>Methods: </strong>Eighty patients were randomly assigned to either the intervention group (receiving PSB + RSB, <i>n</i> = 40) or the control group (not receiving PSB + RSB, <i>n</i> = 40). The primary outcome was opioid consumption within the first 24 h postoperatively. Secondary outcomes included Visual Analog Scale (VAS) pain scores and various surgery and recovery-related parameters.</p><p><strong>Results: </strong>The intervention group showed significantly reduced opioid consumption in the first 24 h postoperatively compared to the control group (<i>P</i> < 0.05), though no significant difference was observed at 48 h postoperatively. VAS pain scores at extubation and at 12, 24, and 48 h post-extubation were significantly lower in the intervention group (<i>P</i> < 0.05). The intervention group also demonstrated superior Quality of Recovery-15 (QoR-15) scores at all observed time points compared to the control group (<i>P</i> < 0.05), with no block-related adverse events. There were no significant differences in surgical and recovery-related parameters between the groups.</p><p><strong>Conclusion: </strong>Ultrasound-guided bilateral PSB combined with RSB effectively enhances postoperative analgesia and the quality of recovery in patients undergoing median sternotomy for cardiac surgery. The application of ultrasound-guided bilateral parasternal block combined with rectus sheath block in median sternotomy cardiac surgery offers a new pain management strategy that is both safe and highly effective. This approach reduces postoperative analgesic requirements and improves recovery quality for cardiac surgery patients.</p><p><strong>Clinical trial registration: </strong>https://www.chictr.org.cn/showproj.html?proj=180456, China Clinical Trial Registry (ChiCTR2200064733).</p>","PeriodicalId":12564,"journal":{"name":"Frontiers in Surgery","volume":"12 ","pages":"1526890"},"PeriodicalIF":1.6000,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11882555/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Frontiers in Surgery","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.3389/fsurg.2025.1526890","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/1 0:00:00","PubModel":"eCollection","JCR":"Q2","JCRName":"SURGERY","Score":null,"Total":0}
引用次数: 0
Abstract
Objective: This study aimed to investigate the effects of ultrasound-guided bilateral parasternal block (PSB) combined with rectus sheath block (RSB) on postoperative recovery quality in patients undergoing median sternotomy for cardiac surgery.
Methods: Eighty patients were randomly assigned to either the intervention group (receiving PSB + RSB, n = 40) or the control group (not receiving PSB + RSB, n = 40). The primary outcome was opioid consumption within the first 24 h postoperatively. Secondary outcomes included Visual Analog Scale (VAS) pain scores and various surgery and recovery-related parameters.
Results: The intervention group showed significantly reduced opioid consumption in the first 24 h postoperatively compared to the control group (P < 0.05), though no significant difference was observed at 48 h postoperatively. VAS pain scores at extubation and at 12, 24, and 48 h post-extubation were significantly lower in the intervention group (P < 0.05). The intervention group also demonstrated superior Quality of Recovery-15 (QoR-15) scores at all observed time points compared to the control group (P < 0.05), with no block-related adverse events. There were no significant differences in surgical and recovery-related parameters between the groups.
Conclusion: Ultrasound-guided bilateral PSB combined with RSB effectively enhances postoperative analgesia and the quality of recovery in patients undergoing median sternotomy for cardiac surgery. The application of ultrasound-guided bilateral parasternal block combined with rectus sheath block in median sternotomy cardiac surgery offers a new pain management strategy that is both safe and highly effective. This approach reduces postoperative analgesic requirements and improves recovery quality for cardiac surgery patients.
Clinical trial registration: https://www.chictr.org.cn/showproj.html?proj=180456, China Clinical Trial Registry (ChiCTR2200064733).
期刊介绍：
Evidence of surgical interventions go back to prehistoric times. Since then, the field of surgery has developed into a complex array of specialties and procedures, particularly with the advent of microsurgery, lasers and minimally invasive techniques. The advanced skills now required from surgeons has led to ever increasing specialization, though these still share important fundamental principles.
Frontiers in Surgery is the umbrella journal representing the publication interests of all surgical specialties. It is divided into several “Specialty Sections” listed below. All these sections have their own Specialty Chief Editor, Editorial Board and homepage, but all articles carry the citation Frontiers in Surgery.
Frontiers in Surgery calls upon medical professionals and scientists from all surgical specialties to publish their experimental and clinical studies in this journal. By assembling all surgical specialties, which nonetheless retain their independence, under the common umbrella of Frontiers in Surgery, a powerful publication venue is created. Since there is often overlap and common ground between the different surgical specialties, assembly of all surgical disciplines into a single journal will foster a collaborative dialogue amongst the surgical community. This means that publications, which are also of interest to other surgical specialties, will reach a wider audience and have greater impact.
The aim of this multidisciplinary journal is to create a discussion and knowledge platform of advances and research findings in surgical practice today to continuously improve clinical management of patients and foster innovation in this field.
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