Efficacy of Multiple Nerve Blocks on the Recovery of Patients Undergoing Off Pump CABG Surgeries

NCT07794527 — Not applicable, Recruiting, 30 participants, Ain Shams University

ClinicalTrials Daily · Areas · Conditions · Drugs · Sponsors ·

Enhancement of the Recovery Profile in Patients Undergoing Off-Pump Coronary Artery Bypass Graft Surgery Through Combination of Multiple Regional Nerve Blocks

Registry	NCT07794527
Status	Recruiting
Phase	Not applicable
Study type	Interventional; randomized, parallel, masking: quadruple, prevention
Enrollment	30 (Estimated)
Sponsor	Ain Shams University (Other)
Conditions	Ischemic Heart Disease (IHD), Off-pump Coronary Artery Bypass, Regional Block for Pain Control
Interventions	regional nerve block with local anesthesia, Placebo (Procedure)
Dates	start 2026-09-10 (estimated), primary completion 2027-03-31 (estimated), completion 2027-04-07 (estimated), first posted 2026-08-31, last updated 2026-08-31
Locations	1 site in Egypt

-Summary

In cardiac surgery patients , effective pain control is crucial to support early extubation, mobilization, and cognitive recovery, yet systemic opioids carry substantial risks such as respiratory depression, delirium, and delayed rehabilitation. While regional fascial plane blocks offer a safer, opioid-sparing alternative, no single technique provides complete analgesia for the complex and multi-dermatomal pain generated by sternotomy, graft harvesting, chest wall retraction, and drain sites. Therefore, a multimodal approach combining blocks such as parasternal nerve block , rectus sheath nerve block and femoral nerve block , may cover most of areas expected to be sources of intraoperative and post-operative pain in cardiac surgery patients.

Expand all sections · Collapse all

+Arms and interventions

Arm	Type	Interventions	Description
Group A (intervention)	Active comparator	Procedure: regional nerve block with local anesthesia	Patients in this group will receive standardized general anaesthesia with a preemptive bilateral superficial parasternal nerve block using 20 mL of 0.25% bupivacaine per side, in combination with a rectus sheath block (RSB) using 10 mL of 0.25% bupivacaine per side. and femoral nerve block at the side of harvesting using 10 mL of 0.25% bupivacaine.
Group B ( control)	Placebo comparator	Procedure: Placebo	Patients will receive standardized general anesthesia with placebo (saline) injections administered in the same anatomical planes.

regional nerve block with local anesthesia (Procedure): Patients will receive bilateral superficial parasternal nerve block using 20 mL of 0.25% bupivacaine per side, in combination with a rectus sheath block (RSB) using 10 mL of 0.25% bupivacaine per side. and femoral nerve block at the side of harvesting using 10 mL of 0.25% bupivacaine.
Placebo (Procedure): Patients will receive placebo (saline) injections administered in the same anatomical planes.

+Outcome measures

Primary outcomes

Time to Extubation [from transferal to ICU until successful tracheal extubation assessed during post operative ICU stay up to 48 hours]: Defined as the interval (in hours) from transferal to ICU to successful tracheal extubation

+Eligibility

Sex: All, ages: 18 Years to 65 Years

Inclusion Criteria:

* o Scheduled for elective off-pump coronary artery bypass graft (OPCAB) surgery via median sternotomy

  * American Society of Anesthesiologists (ASA) physical status III - IV
  * Ability to provide informed consent

Exclusion Criteria:

* o Emergency or redo cardiac surgery

  * On-pump CABG or concomitant valve or aortic procedures
  * Known allergy to local anesthetics or study drugs
  * Coagulopathy or ongoing anticoagulant therapy contraindicating regional block
  * Preoperative chronic opioid use or opioid dependency
  * Neurologic or psychiatric conditions interfering with pain assessment
  * Infection at the block injection site
  * Severe hepatic or renal impairment
  * Body mass index (BMI) > 40 kg/m²
  * Inability to understand or cooperate with pain scoring or postoperative care.

+Locations (1)

Facility	City	Country	Status
Ain shams university hospitals	Cairo	Egypt	Recruiting

+Investigators

Sherif S Sultan, MD, Study director, faculty of medicine Ain Shams university