Efficacy of Superficial versus Deep Parasternal Intercostal Plane Blocks in Cardiac Surgery: A Systematic Review and Meta-Analysis.

IF 2.3 4区医学 Q2 ANESTHESIOLOGY

Journal of cardiothoracic and vascular anesthesia Pub Date : 2025-05-29 DOI:10.1053/j.jvca.2025.05.053

Burhan Dost, Alessandro De Cassai, Yunus Emre Karapinar, Esra Turunc, Muzeyyen Beldagli, Mirac Selcen Ozkal Yalin, Paolo Navalesi

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引用次数: 0

Abstract

Objectives: To compare the analgesic efficacy of superficial parasternal intercostal plane (S-PIP) block and deep parasternal intercostal plane (D-PIP) to determine which technique provides superior pain relief in cardiac surgery.

Design: A systematic search of MEDLINE (via PubMed), Scopus, Embase, Cochrane Library, Web of Science, Google Scholar, and ClinicalTrials.gov from inception until January 18, 2025. Eligible studies included randomized controlled trials (RCTs) and observational studies that compared the S-PIP and D-PIP blocks in patients undergoing cardiac surgery. The primary outcome of the study was postoperative opioid consumption of morphine milligram equivalent (MME) at 24 hours. Secondary outcomes included resting and movement pain scores at 0, 6, 12 and 24 hours, time to first analgesics, incidence of postoperative nausea and vomiting (PONV), extubation time, length of stay (LOS) in the intensive care unit (ICU), and the number of patients requiring rescue analgesics.

Main results: Seven RCTs and 1 observational study, including a total of 510 patients, were identified. The findings demonstrated no statistically significant difference in MME at 24 hours between the S-PIP and D-PIP block groups (mean difference, -1.23; 95% confidence interval, -2.51 to 0.05; p = 0.061). Additionally, there were no significant differences in pain scores, PONV incidence, time to rescue analgesics, extubation time, or ICU LOS of stay between the 2 techniques.

Conclusions: S-PIP and D-PIP blocks provide comparable postoperative analgesic efficacy in patients undergoing cardiac surgery.

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浅表与深胸骨旁肋间平面阻滞在心脏手术中的疗效：系统回顾和荟萃分析。

目的：比较浅胸骨旁肋间面阻滞（S-PIP）和深胸骨旁肋间面阻滞（D-PIP）的镇痛效果，以确定哪种技术在心脏手术中镇痛效果更好。设计：系统搜索MEDLINE（通过PubMed）， Scopus, Embase, Cochrane Library, Web of Science，谷歌Scholar和ClinicalTrials.gov从成立到2025年1月18日。符合条件的研究包括随机对照试验（rct）和观察性研究，比较心脏手术患者的S-PIP和D-PIP阻滞。该研究的主要结局是术后24小时吗啡毫克当量（MME）阿片类药物消耗。次要结局包括静息和运动疼痛评分0、6、12和24小时，首次使用镇痛药的时间，术后恶心呕吐发生率（PONV），拔管时间，重症监护病房（ICU）住院时间（LOS），以及需要急救镇痛药的患者人数。主要结果：共纳入7项rct和1项观察性研究，共纳入510例患者。结果显示，S-PIP和D-PIP阻滞组24小时MME无统计学差异(平均差异为-1.23；95%置信区间为-2.51 ~ 0.05；P = 0.061)。此外，两种技术在疼痛评分、PONV发生率、镇痛药物抢救时间、拔管时间或ICU住院时间方面无显著差异。结论：S-PIP和D-PIP阻滞对心脏手术患者的术后镇痛效果相当。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of cardiothoracic and vascular anesthesia 医学-呼吸系统

CiteScore

4.80

自引率

17.90%

发文量

606

审稿时长

37 days

期刊介绍： The Journal of Cardiothoracic and Vascular Anesthesia is primarily aimed at anesthesiologists who deal with patients undergoing cardiac, thoracic or vascular surgical procedures. JCVA features a multidisciplinary approach, with contributions from cardiac, vascular and thoracic surgeons, cardiologists, and other related specialists. Emphasis is placed on rapid publication of clinically relevant material.