Cardiothoracic & vascular anesthesia
Efficacy of bilateral catheter superficial parasternal intercostal plane blocks using programmed intermittent bolus for opioid-sparing postoperative analgesia in cardiac surgery with sternotomy: A randomized, double-blind, placebo-controlled trial
Authors' conclusion
Bilateral catheter SPIP blocks using PIB with ropivacaine reduced opioid consumption over 48 h, concurrently delivering superior postoperative analgesia in adult cardiac surgery with sternotomy.
Study context
- Population
- Adults (≥18 y) scheduled for cardiac surgery via sternotomy, university-affiliated tertiary hospital; all received hydromorphone PCA
- Participants
- 60 adults
- Comparison
- Bilateral catheter superficial parasternal intercostal plane (SPIP) blocks with programmed intermittent bolus (PIB) ropivacaine vs saline
- Primary endpoint
- Cumulative morphine equivalent consumption
- Follow-up
- 48 h after surgery
Methodological detailsdouble-blind, prospective, placebo-controlled, single-centre
- Double-blind
- Prospective
- Placebo-controlled
- Single-centre
Primary result
As reported in the abstract
95% CI −81.9 to −20.0; P = 0.002
Secondary outcomes
Numeric Rating Scale (NRS) pain scores (rest and coughing) · all recorded time points
- Lower NRS scores in the ropivacaine group at all recorded time points
- P < 0.05
Ambulation
- Significant improvement in the ropivacaine group vs saline
- P = 0.018
Respiratory exercises
- Significant improvement in the ropivacaine group vs saline
- P = 0.006
Self-reported analgesia satisfaction
- Significant improvement in the ropivacaine group vs saline
- P = 0.016
Safety
| Outcome | Ropivacaine | Saline | P value |
|---|---|---|---|
| Nausea and vomiting | 3/29 | 12/29 | P = 0.007 |
Original publication
Efficacy of bilateral catheter superficial parasternal intercostal plane blocks using programmed intermittent bolus for opioid-sparing postoperative analgesia in cardiac surgery with sternotomy: A randomized, double-blind, placebo-controlled trial. J Clin Anesth. Published 26 March 2024. doi:10.
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