Hemodynamic Stability Clinical Trial
Official title:
Bilateral Ultrasound Guided Pectoralis Nerve Block Induces Hemodynamic Stability With Reducing Systemic Stress Response for Adult Patients Undergoing Off-pump Coronary Artery Bypass Graft
Opioids used in attenuation of the neuroendocrine stress response in patients undergoing off-pump coronary artery bypass graft (OPCAB) it produces predictable satisfactory analgesia and sedation but with side effects such as respiratory depression, drowsiness, and myocardial depression. Regional techniques may be encouraged to be anti-stress procedures and produce risk‑free postoperative (OPCAB) period. Pectoralis nerve block (pecs block) appears to possess a great deal of promise for patients undergoing (OPCAB) because of low complication rates as it is less invasive regional analgesic technique when compared to paravertebral, thoracic epidural analgesia and parenteral analgesia.
Aims: Ultrasound Guided Bilateral Pecs block would provide attenuation of the neuroendocrine
stress response with hemodynamic profile stability, decreased analgesic consumption and
improves patient postoperative outcomes after(OPCAB).
Materials and Methods: A prospective, single-blind, controlled study enrolled forty patients
between the age groups of 25 and 65 years undergoing (OPCAB) through midline sternotomy under
general anesthesia and randomly allocated into two groups with 20 in each group. Group 1
patients did not receive Pecs block (control group), patients were anesthetized to keep the
heart rate and blood pressure within 25% of the baseline values. Whereas Group 2 patients
received bilateral Pecs block preoperatively. Patients were extubated once they fulfilled
extubation criteria. Heart rate, mean arterial blood pressure, Plasma levels of
adrenocorticotropic hormone(ACTH) and cortisol, sufentanil consumption were determined at the
following points: Basically (T0),immediately before the induction of anesthesia; (T1),
immediately after tracheal intubation; (T2),immediately after sternotomy;( T3), 30 minutes
after the start of surgery; and (T4), at the end of surgery. Ventilator duration, duration of
ICU stay hospital stay were recorded postoperatively.
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