An interventional study of Parasternal/ Rectus sheath block and Erector spinae plane block in Analgesia, Perioperative Analgesia and Regional Block Technique, sponsored by National Cancer Institute, Egypt. Not yet recruiting. Open to participants aged 18 Years to 80 Years. Per ClinicalTrials.gov, last updated 2026-07-13.
Sponsored by National Cancer Institute, Egypt · Not applicable, Interventional, and Treatment
The researchers are working to improve recovery after heart surgery by reducing reliance on opioids. Newer regional anesthesia techniques can provide strong pain relief with fewer risks, but the choice of method depends on each patient's condition, medications, and surgical plan
Optimal anesthesia in cardiac surgery requires careful management to avoid sympathetic stimulation, with analgesia being central to patient safety and recovery. Traditionally, high-dose opioids were used, but this approach delays extubation, conflicting with fast-track protocols that emphasize early extubation. Consequently, opioid-free analgesia has gained importance, employing regional techniques such as neuraxial, paravertebral, and fascial plane blocks.
Thoracic epidural analgesia (TEA) offers effective pain control and reduces perioperative cardiovascular and respiratory complications. However, its use in anticoagulated patients raises concern for epidural hematoma. Alternatives like paravertebral and fascial plane blocks provide comparable analgesia with lower risk. The erector spinae plane block (ESPB) reduces analgesic requirements, though deep blocks still pose bleeding risks.
Superficial plane blocks are therefore clinically valuable. The parasternal intercostal block-targeting anterior cutaneous branches of intercostal nerves-has emerged as a safe option for patients undergoing median sternotomy while on anticoagulant or antiplatelet therapy. Additionally, bilateral rectus sheath block can reduce chest tube insertion pain after cardiac surgery.
National Cancer Institute, Egypt is the lead sponsor of 133 studies on the registry; 29 are open to participants now.
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Exclusion Criteria:
Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
The anaesthetists’ scale of health before surgery: I is healthy, II has a mild illness that is under control, III a severe one, IV a severe illness that is a constant threat to life. V and VI are used for the critically ill and for organ donors.
Weight in kilograms divided by height in metres squared. Example: 70 kg and 1.75 m gives 70 ÷ (1.75 × 1.75) ≈ 22.9.
What counts as overweight or obesity differs between countries (some use lower cut-offs), so go by the range the study states.
The share of blood the heart’s main pumping chamber (the left ventricle) pushes out with each beat, measured by an echocardiogram (heart ultrasound) or a MUGA scan. About 50–70% is normal.
Blood cells that help blood clot. Too few raises the risk of bleeding and bruising. A usual adult range is about 150–400 × 10⁹/L (150,000–400,000 per µL); each lab has its own reference range.
ASA physical status
The anaesthetists’ scale of health before surgery: I is healthy, II has a mild illness that is under control, III a severe one, IV a severe illness that is a constant threat to life. V and VI are used for the critically ill and for organ donors.
Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
BMI (body mass index)
Weight in kilograms divided by height in metres squared. Example: 70 kg and 1.75 m gives 70 ÷ (1.75 × 1.75) ≈ 22.9.
What counts as overweight or obesity differs between countries (some use lower cut-offs), so go by the range the study states.
Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
LVEF (left ventricular ejection fraction)
The share of blood the heart’s main pumping chamber (the left ventricle) pushes out with each beat, measured by an echocardiogram (heart ultrasound) or a MUGA scan. About 50–70% is normal.
Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
Platelets
Blood cells that help blood clot. Too few raises the risk of bleeding and bruising. A usual adult range is about 150–400 × 10⁹/L (150,000–400,000 per µL); each lab has its own reference range.
Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
Patients will receive Parasternal and rectus sheath blocks; with injection of 10 ml bupivacaine 0.25% in each side after confirmation of needle position. Both parasternal and rectus heath blocks will be performed bilaterally
Procedure: Parasternal/ Rectus sheath block
The patients will receive a bilateral ESPB with an injection of 20 ml of bupivacaine 0.25%.
Procedure: Erector spinae plane block
the parasternal block will be performed parasternally at the level of fifth rib to the plane between the pectoralis major and the internal intercostal muscle. The rectus sheath block will be performed through injection in the plane posterior to the rectus abdominis muscle and anterior to the posterior rectus sheath
injection above the transverse process
Numeric rating score
postoperative pain scores using Numerical Rating Scale (NRS) with 0 meaning no pain and 10 meaning the worst pain level
Time frame: 24 hours
postoperative opioid consumption
opioid consumption in the first 24 hours postoperatively
Time frame: 24 hours
extubation time
time to extubate
Time frame: immediate postoperative
first time to request analgesia
first time to request opioid analgesia
Time frame: 24 hours
peri-operative hemodynamics
incidence of hypotension, hypertension, tachycardia and bradycardia
Time frame: intraoperative and 24 hours
No study locations are listed for this record.
Start is estimated for Jul 2026; primary completion for Jun 2027, 11 months later.
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This study is not yet recruiting, as verified in Jul 2026. You cannot join it, but the record below documents what was studied.
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Agnosia
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