The Effect of Repeated Bilateral Deep Parasternal Intercostal Plane Catheter Boluses on Analgesia After Cardiac Surgery: A Randomized Controlled Trial

doi:10.1213/ane.0000000000008211

Cardiothoracic & vascular anaesthesia

The Effect of Repeated Bilateral Deep Parasternal Intercostal Plane Catheter Boluses on Analgesia After Cardiac Surgery: A Randomized Controlled Trial

Anesth AnalgPublished 11 Aug 2026Randomised controlled trial

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Authors' conclusion

Repeated ropivacaine boluses via DPIP catheters did not improve postoperative pain control or reduce opioid consumption compared with placebo after median sternotomy.

Study context

Population: Adults undergoing elective CABG or heart valve replacement via median sternotomy
Participants: 120 adults

Comparison: R vs P
Primary endpoint: Postoperative pain intensity (VAS or, in sedated patients, behavioral pain scale)
Follow-up: 72 hours

Methodological detailsplacebo-controlled, blinded (patients, researchers, clinical staff)

Placebo-controlled
Blinded (patients, researchers, clinical staff)

Primary result

As reported in the abstract

Pain trajectories · 72-hour postoperative period

Pain trajectories did not differ between groups at rest: P = .77
Pain trajectories did not differ between groups with movement: P = 1.00

Secondary outcomes

Cumulative oxycodone dose · 12 to 24 hours

P = 0.32

Rmedian 30 mg95% CI for median 24–39

Pmedian 24 mg95% CI for median 21–30

Cumulative oxycodone dose · 24 to 48 hours

P = 0.23

Rmedian 48 mg95% CI for median 39–66

Pmedian 39 mg95% CI for median 33–45

Cumulative oxycodone dose · 48 to 72 hours

P = 0.21

Rmedian 24 mg95% CI for median 12–33

Pmedian 18 mg95% CI for median 12–24

Time until extubation

Rmedian 340 minutesIQR 289–539

Pmedian 348 minutesIQR 278–412

95% CI for median R 400-650 · P 337-446

Cumulative oxycodone dose: first 12 h: median 24 mg (18-27), P = .55

Time until extubation

Postoperative sedation and mechanical ventilation times did not differ between groups

Safety

PONV

R46.7%

P30%

PONV, valve surgery patients (subgroup)

P = 0.012

R60.6%

P26.5%

PONV — Most common adverse event, overall: 38%

PONV: denominators 60 per group
PONV, valve surgery patients (subgroup): denominators 34 (P) and 33 (R)

Other adverse events

Symptoms suggestive of LAST, all self-limiting: 5
Pneumothoraces (one clearly surgically related): 4
Catheter dislodged: 9
Pain during injection among dropouts (suboptimal catheter positioning): 3

Original publication

The Effect of Repeated Bilateral Deep Parasternal Intercostal Plane Catheter Boluses on Analgesia After Cardiac Surgery: A Randomized Controlled Trial. Anesth Analg. Published 11 August 2026. doi:10.1213/ane.0000000000008211

Read the original article ↗

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