Efficacy of ultrasound-guided pecto-intercostal fascial block and transversus thoracis muscle plane block for postoperative analgesia in cardiac surgery in adult patients: A randomized study

Figures & data

Figure 1. (a) sonoanatomy of anterior chest wall, (b): pecto-intercostal fascial plane block, (c) transversus thoracis plane block.

PPM, pectoralis major muscle; ICM, intercostal muscle; TTM, transverse thoracic muscle, LA, local anesthetic

Figure 2. The CONSORT flow graphic illustrates the progression of participants at each stage of the randomized study.

Table 1. Demographic characteristics, type of operations, cross-clamping time, duration of operations, type and intraoperative fentanyl consumption in three studied groups.

		Control (n = 30)	PIFB (n = 30)	TTB (n = 30)
Age (years)		48 ± 11	46 ± 10	47 ± 10
Sex	Male	18 (60.0%)	15 (50.0%)	16 (53.3%)
	Female	12 (40.0%)	15 (50.0%)	14 (46.7%)
Weight (kg)		85 ± 8	86 ± 8	85 ± 9
Type of operations	Mitral valve replacement	9 (30.0%)	12 (40.0%)	10 (33.3%)
	Aortic valve replacement	3 (10.0%)	5 (16.7%)	7 (23.3%)
	Mitral valve replacement and tricuspid valve repair	11 (36.7%)	9 (30.0%)	8 (26.7%)
	Double mitral and aortic replacement	7 (23.3%)	4 (13.3%)	5 (16.7%)
Cross clamping time (min)		61 ± 12	59 ± 14	60 ± 16
Duration of operation (min)		275 ± 50	276 ± 56	268 ± 55
Intraoperative fentanyl (µg)		601 ± 58	602 ± 60	594 ± 64

Data are demonstrated as mean ± SD or frequency. PIFB: pecto-intercostal fascial block, TTB: transversus thoracis muscle plane. There were no statistically significant differences between the three groups.

Table 2. Comparison among the three studied groups according to (NRS).

NRS	Control group (n = 30)	PIFB group (n = 30)	TTB group (n = 30)	p	Significance among groups
					p1	p2	p3
Zero hr.	3 (2.0 – 3.0)	1 (1 – 2)	2 (1 – 3)	0.002*	0.001*	0.011*	0.359
Three hr.	5 (3.0 – 6.0)	1 (1 – 2)	2 (1 – 3)	<0.001*	<0.001*	<0.001*	0.194
Six hr.	4 (3 – 5)	1 (1 – 3)	2 (1 – 3)	<0.001*	<0.001*	0.001*	0.360
Twelve hr.	4 (3 – 4)	3 (2 – 4)	3 (2 – 4)	0.068	–	–	–
Twenty-four hr.	4 (3 – 4)	3 (3 – 4)	3 (2 – 4)	0.053	–	–	–

Data are demonstrated as Median (IQR). NRS: numeric rating scale, PIFB: pecto-intercostal fascial block, TTB: transversus thoracis muscle plane, p1: p, p2: p, p3: p, * Significant compared to the Control group (p value < 0.05).

Table 3. Comparison between the three studied groups according to time to postoperative analgesia, first analgesic request, and consumption of postoperative analgesia.

	Control	PIFB	TTB
Time to 1^st analgesic request (min.)
Min. – Max.	10 – 720	10 – 1440	12 – 1440
Median (IQR)	180 (180 – 360)	720 (360 – 1440)	360 (180 – 1440)
H	14.473*
p	0.001*
Significance among groups	p1 <0.001*, p2 = 0.018*, p3 = 0.172
Consumption of postoperative analgesia(ug)
Min. – Max.	40.0 – 212	0 – 243	0 – 205
Median ((IQR))	92 (83 – 140)	40.5 (0 – 53)	44 (38 – 80)
H	27.588*
p	<0.001*
Significance among groups	p1 <0.001*, p2 <0.001*, p3 = 0.467

Data are demonstrated as Median (IQR). PIFB: pecto-intercostal fascial block, TTB: transversus thoracis muscle plane, p1: p, p2: p, p3: p, * Significant compared to the Control group (p value < 0.05). H: H for Kruskal Wallis test.