Fascial Plane Blocks and Quality of Recovery in Cardiac Surgery

Summary

In this randomized trial, we will test the hypothesis that combining regional analgesia techniques-which have the potential to improve the quality of postoperative recovery following median sternotomy-with PIFB will accelerate recovery. Additionally, it is anticipated that RIFB, an alternative fascial plane block, will demonstrate non-inferior (at least as effective as) performance compared to RSB, thereby providing flexibility and ease of application in clinical practice.

Eligibility

Inclusion Criteria:

* Patients who have provided written informed consent
* Open-heart surgery performed under elective conditions via median sternotomy with cardiopulmonary bypass (on-pump)
* American Society of Anesthesiologists (ASA) physical status class II or III
* Aged 18-70 years

Exclusion Criteria:

* Off-pump surgical procedure
* Emergency or repeat cardiac surgery
* Known allergy to induction agents or local anesthetics
* Body mass index (BMI) \>35 kg/m²
* Coagulopathy
* Infection at the surgical site
* Left ventricular ejection fraction (LVEF) \<40%
* Renal insufficiency (estimated glomerular filtration rate \<60 mL/min/1.73 m²) or hepatic insufficiency \[Presence of major systemic diseases such as acute decompensated cirrhosis characterized by bilirubin \>12 mg/dL, INR \>2.5, or hepatic encephalopathy, in accordance with the European Association for the Study of the Liver-Chronic Liver Failure Consortium criteria\]
* Psychiatric disorders
* History of chronic pain or regular use of analgesics (corticosteroids, analgesics, anticonvulsants)
* Cognitive impairments that could interfere with the assessment of postoperative pain
* Patients with impaired physical and verbal performance

Conditions4

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