Introduction
Methods
Anesthetic procedure
Intervention
Ultrasound-guided TTMPB procedure
Ultrasound-guided PIFB procedure
Recovery and postoperative period
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Characteristic information: Age, gender, Body Mass Index (BMI), and ASA physical status
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Time required to adopt the procedure (minutes) (i.e., from placing the ultrasound probe on the patient’s skin to the termination of LA administration)
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Anesthesia duration and extubation time (i.e., since transmission to ICU to extubation)
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Heart rate (HR) and mean arterial blood pressure (MBP)
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The VAS scores for sternal pain at rest and with cough (range: 0–10 indicative of no and extreme pain, respectively) were recorded [15]. Pain relief is shown with a score of ≤ 3. Supplemental rescue analgesia i.e., morphine 0.05 mg/kg (at VAS ≥ 4) was intravenously provided.
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The first time for rescue analgesia (minute) is the time taken to raise a request for the initial postoperative analgesia (morphine) and was estimated from extubation to patient reporting a VAS score of ≥ 4.
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Overall dosage of rescue analgesia (morphine) (i.e., primary outcome) used in the initial 24 h after the surgery.
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The data regarding postoperative complications (e.g., bradycardia, hypotension, sedation, respiratory depression, nausea, and vomiting), throughout the initial 24 h after surgery, was collected. In order to evaluate nausea and vomiting, categorical scoring was employed with 0, 1, 2, and 3 indicating none, nausea, retching, and vomiting, respectively [16]. Sedation scale was applied to determine the sedation scores (0 = awake, 1 = drowsy, 2 = asleep but arousable, and 3 = deeply asleep). A sedation score of > 0 indicates being sedated at any time throughout the initial postoperative 24 h [17].
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Patient satisfaction was evaluated as follows; 1 = poor, 2 = moderate, 3 = good, and 4 = perfect [18].
Sample size
Statistical analysis
Results
TTMPB (n = 40) | PIFB (n = 40) | p value | |
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Age (years) | 53.3 ± 15.2 | 52.7 ± 15.8 | 0.880 |
Males/Females | 28/12 | 29/11 | 0.805 |
BMI (kg/m2) | 30.1 ± 6.7 | 34.3 ± 8.6 | 0.017 |
ASA I/ II/ III | 7/23/10 | 0/29/11 | 0.021 |
TTMPB (n = 40) | PIFB (n = 40) | p value | |
---|---|---|---|
Time needed to perform technique (min) | 4.2 ± 0.8 | 4.1 ± 0.8 | 0.490 |
Anesthesia duration (min) | 286.4 ± 33.5 | 279.1 ± 40.4 | 0.380 |
Time to extubation (min) | 250.0 ± 64.0 | 250.5 ± 82.4 | 0.976 |
TTMPB (n = 40) | PIFB (n = 40) | p value | |
---|---|---|---|
VAS at extubation | 0 (0–2) | 0 (0–2) | 0.859 |
VAS-3h after extubation | 0 (0–2) | 0 (0–2) | 0.601 |
VAS-6h after extubation | 1 (0–3) | 1 (0–3) | 0.210 |
VAS-12h after extubation | 2 (0–5) | 2 (0–3) | 0.069 |
VAS-18h after extubation | 2 (0–4) | 2 (0–3) | 0.004 |
VAS-24h after extubation | 1.5 (0–3) | 1 (0–3) | 0.106 |
P value (over time) | < 0.001 | < 0.001 |
TTMPB (n = 40) | PIFB (n = 40) | p value | |
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VAS at extubation | 2 (0–2) | 1 (0–3) | 0.252 |
VAS-3h after extubation | 1 (0–2) | 1 (0–3) | 0.527 |
VAS-6h after extubation | 2 (1–4) | 3 (0–4) | 0.388 |
VAS-12h after extubation | 3 (1–5) | 2 (0–4) | < 0.001 |
VAS-18h after extubation | 3 (1–4) | 2 (0–4) | < 0.001 |
VAS-24h after extubation | 1.5 (1–4) | 2 (0–3) | 1.000 |
P value (over time) | < 0.001 | < 0.001 |
TTMPB (n = 40) | PIFB (n = 40) | p value | |
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Time to first request of rescue analgesic (h) | 6.7 ± 1.4 | 7.8 ± 1.7 | 0.003 |
Total morphine-24h (mg) | 7.8 ± 2.0 | 4.8 ± 1.0 | < 0.001 |
TTMPB (n = 40) | PIFB (n = 40) | p value | |
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Nausea & Vomiting: | |||
- None | 32 (80%) | 36 (90%) | 0.335 |
- Nausea | 4 (10%) | 2 (5%) | |
- Retching | 4 (10%) | 2 (5%) | |
- Vomiting | 0 (0%) | 0 (0%) | |
Sedation: | |||
- Awake | 32 (80%) | 32 (80%) | 0.539 |
- Drowsy | 5 (13%) | 4 (10%) | |
- Asleep but arousable | 2 (5%) | 2 (5%) | |
- Deep sleep | 1 (3%) | 2 (5%) | |
Satisfaction | |||
- Poor | 3 (8%) | 2 (5%) | 0.373 |
- Moderate | 8 (20%) | 3 (8%) | |
- Good | 16 (40%) | 18 (45%) | |
- Perfect | 13 (33%) | 17 (43%) |