The Effectiveness of Bilateral Pectoralis Nerve Block in Cardiac Surgery Patients for Managing Postoperative Pain

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dc.contributor.authorDas, Rajat Shuvraen_US
dc.contributor.authorHoque, A.K.M. Faizulen_US
dc.contributor.authorSultana, Ayeshaen_US
dc.contributor.authorHannan, Mohammad Abdulen_US
dc.contributor.authorHassan, Mehdien_US
dc.contributor.authorKarmakar, Chandra Shekharen_US
dc.contributor.authorJahan, A B M Sarwaren_US
dc.contributor.authorSiddique, Muhammed Sharif Uddinen_US
dc.contributor.authorHabibullah, AKMen_US
dc.date.accessioned2024-12-07T11:12:01Z
dc.date.available2024-12-07T11:12:01Z
dc.date.issued2024-01
dc.description.abstractBackground: Effective pain management following cardiac surgery contributes to enhanced recovery and increased mobility. But the coagulation status of the cardiac surgery patients makes neuraxial blocks risky. An alternative to neuraxial blocks for post operative pain management after adult cardiac surgeries is the Pectoralis Nerve (Pecs) block. This innovative technique offers a safe and minimally invasive approach for post operative pain management after adult cardiac surgeries. The objective of the study was to investigate the effectiveness of bilateral pectoralis nerve block in cardiac surgery with regards to enhanced recovery and postoperative pain management. Material & Methods: This was a quasi-experimental study and was conducted in the Department of Anaesthesia, Analgesia and Intensive care medicine of Bangabandhu Sheikh Mujib Medical University (BSMMU) Hospital, Dhaka, Bangladesh during the period from January 2023 to June 2023. This study involved 40 adult cardiac surgery patients (25-65 years) undergoing coronary artery bypass grafting and valve repair or replacement surgeries via midline sternotomy. They were divided into two groups: Group A received conventional analgesia with intravenous paracetamol 01 gm TDS with continuous intravevous infusion of 1 microgram per kg body weight of fentanyl, and Group B received ultrasound guided bilateral Pectoral Nerve (PEC) block with volume of 0.2 ml per kg body weight of 0.25% bupivacaine with 5 mg of dexamethasone for each interfacial plane . Extubation criteria were used, and data were collected through a questionnaire for visual analogue score and vital parameters such as heart rate , blood pressure, respiratory rate , duration on invasive ventilation at 0 hour, 02 hour, 04 hour, 08 hour and 12 hour post operatively. Results: In total 40 patients from both the groups completed the study. The study found no significant differences in vital parameters between Group A and Group B. Group B showed significantly lower pain scores upto 12 hours post-extubation. Respiratory rate was significantly lower in Group B at six assessment times. No significant differences were observed in hemodynamic variables. Group B had a shorter ICU stay compared to Group A, but no significant difference in hospital stays or duration of ventilator use between the groups. Conclusions: The Pectoral Nerve (Pecs) block is an effective and less invasive and safe procedure for managing postoperative pain and enhancing recovery in adult cardiac surgeries such as CABG, valve repair or replacement surgeries with a medial sternotomy.en_US
dc.identifier.affiliationsAssistant Professor, Department of Anaesthesia, Analgesia and Intensive Care Medicine, Bangabandhu Sheikh Mujib Medical University, Shahbag, Dhaka. Email: rajatsdas1351@bsmmu.edu.bd, Orcid Id: 0009-0000-1513-0180en_US
dc.identifier.affiliationsProfessor, Department of Anaesthesia, Analgesia and Intensive Care Medicine, Bangabandhu Sheikh Mujib Medical University, Shahbag, Dhaka. Email: akmfaizul@gmail.com, Orcid ID: 0009-0007-91922957en_US
dc.identifier.affiliationsAssistant Professor, Department of Anaesthesia, Analgesia and Intensive Care Medicine, Bangabandhu Sheikh Mujib Medical University, Shahbag, Dhaka. Email: ayesha814736@gmail, Orcid ID: 0009-0004-9107-6138en_US
dc.identifier.affiliationsAssistant Professor, Department of Anaesthesia, Analgesia and Intensive Care Medicine, Bangabandhu Sheikh Mujib Medical University, Shahbag, Dhaka. Email: drhannan73@gmail.com, Orcid ID: 0009-0006-1949-2756en_US
dc.identifier.affiliationsAssistant Professor, Department of Anaesthesia, Analgesia and Intensive Care Medicine, Bangabandhu Sheikh Mujib Medical University, Shahbag, Dhaka. Email: mehdihassanmmc1@gmail.com, Orcid ID: 0000-0002-4952-4556en_US
dc.identifier.affiliationsAssistant Professor, Department of Anaesthesia, Analgesia and Intensive Care Medicine, Bangabandhu Sheikh Mujib Medical University, Shahbag, Dhaka. Email: tuser.saiful@gmail.com, Orcid ID: 0009-0009-9497-9099en_US
dc.identifier.affiliationsJunior Consultant, Department of Anaesthesia, Analgesia and Intensive Care Medicine, Bangabandhu Sheikh Mujib Medical University, Shahbag, Dhaka. Email: sarwar.mmc31@gmail.com, Orcid ID: 0009-0003-9466-830Xen_US
dc.identifier.affiliationsResident, Department of Anaesthesia, Analgesia and Intensive Care Medicine, Bangabandhu Sheikh Mujib Medical University, Shahbag, Dhakaen_US
dc.identifier.citationDas Rajat Shuvra, Hoque A.K.M. Faizul, Sultana Ayesha, Hannan Mohammad Abdul, Hassan Mehdi, Karmakar Chandra Shekhar, Jahan A B M Sarwar, Siddique Muhammed Sharif Uddin, Habibullah AKM. The Effectiveness of Bilateral Pectoralis Nerve Block in Cardiac Surgery Patients for Managing Postoperative Pain. Annals of International Medical and Dental Research. 2024 Jan; 10(1): 71-78en_US
dc.identifier.issn2395-2822
dc.identifier.issn2395-2814
dc.identifier.placeIndiaen_US
dc.identifier.urihttps://imsear.searo.who.int/handle/123456789/241049
dc.languageenen_US
dc.publisherSociety for Health Care & Research Developmenten_US
dc.relation.issuenumber1en_US
dc.relation.volume10en_US
dc.source.urihttps://doi.org/10.53339/aimdr.2024.10.1.9en_US
dc.subjectCardiac Surgeryen_US
dc.subjectPectoralis Nerve Blocken_US
dc.subjectPain Management.en_US
dc.titleThe Effectiveness of Bilateral Pectoralis Nerve Block in Cardiac Surgery Patients for Managing Postoperative Painen_US
dc.typeJournal Articleen_US
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