Bilateral transversus thoracis muscle plane block provides effective analgesia and enhances recovery after open cardiac surgery

J Card Surg. 2021 Aug;36(8):2818-2823. doi: 10.1111/jocs.15666. Epub 2021 May 28.

Abstract

Background: The mid-sternum is the main source of pain after open cardiac surgery. The aim of this study was to investigate the effect of bilateral transversus thoracis muscle plane (TTMP) blocks on open cardiac surgery.

Methods: Sixty patients were randomly divided into two groups: bilateral TTMP blocks (TP group) or no nerve block (CO group). The primary endpoint was perioperative sufentanil consumption. The secondary outcome measures included postoperative pain, flurbiprofen axetil administration, quality of sleep after extubation, time to extubation, time to the return of gastrointestinal function, time to drain removal, the Intensive Care Unit (ICU) stay time, and hospital stay.

Results: The TP group reported significantly less sufentanil and flurbiprofen axetil consumption than the CO group. The CO group had higher Numerical Rating Scale (NRS) pain scores at 1, 2, 6, 12, and 24 h after extubation both at rest and during movement than the TP groups. Compared with the CO group,time to extubation, time to the first bowel movement, ICU stay time, and hospital stay were significantly decreased in the TP group. The TP group was rated as better in the quality of the two nights of sleep after extubation.

Conclusion: Bilateral TTMP blocks can provide good perioperative analgesia for patients undergoing open cardiac surgery and promote postoperative recovery.

Keywords: Numerical Rating Scale; open cardiac surgery; postoperative pain; sufentanil; the length of hospital stay; the transversus thoracis muscle plane block.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Analgesia*
  • Analgesics, Opioid
  • Cardiac Surgical Procedures*
  • Humans
  • Muscles
  • Pain, Postoperative / prevention & control

Substances

  • Analgesics, Opioid