[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"health-study-detail:100627745":3},{"organization":4,"armGroups":7,"interventions":20,"overallOfficials":26,"centralContacts":26,"locations":35,"responsibleParty":64,"collaborators":26,"id":67,"slug":68,"hasResults":69,"nctId":70,"briefTitle":71,"officialTitle":72,"acronym":26,"eligibilityCriteria":73,"healthyVolunteers":69,"sex":74,"minAge":75,"maxAge":76,"enrollmentInfo":77,"targetDuration":26,"studyType":80,"phases":81,"briefSummary":83,"conditions":84,"keywords":89,"overallStatus":38,"whyStopped":26,"lastUpdateSubmitDate":96,"lastUpdatePostDateStruct":97,"startDateStruct":100,"completionDateStruct":102,"leadSponsor":104,"locationsCount":105},{"fullName":5,"class":6},"Uludag University","OTHER",[8,15],{"label":9,"type":10,"description":11,"interventionNames":12},"TTPB+ SAPB Group","EXPERIMENTAL","Patients in this group will receive a combination of Transversus Thoracic Plane Block and Serratus Anterior Plane Block for postoperative analgesia.",[13,14],"Procedure: TTP Block","Procedure: SAP Block",{"label":16,"type":10,"description":17,"interventionNames":18},"ESPB Group","Patients in this group will receive Erector Spinae Plane Block for postoperative analgesia.",[19],"Procedure: ESP Block",[21,27,31],{"type":22,"name":23,"description":24,"armGroupLabels":25,"otherNames":26},"PROCEDURE","TTP Block","A combination of Transversus Thoracic Plane Block (TTPB) at the T4-T5 level will be performed using 0.25% bupivacaine (0.5 mg\u002Fkg)",[9],null,{"type":22,"name":28,"description":29,"armGroupLabels":30,"otherNames":26},"ESP Block","Erector Spinae Plane Block (ESPB) at the T4 transverse process level will be performed using 0.25% bupivacaine (0.5 mg\u002Fkg)",[16],{"type":22,"name":32,"description":33,"armGroupLabels":34,"otherNames":26},"SAP Block","Serratus Anterior Plane Block (SAPB) at the 5th rib level will be performed using 0.25% bupivacaine (0.5 mg\u002Fkg)",[9],[36],{"facility":37,"status":38,"city":39,"state":40,"zip":41,"country":42,"countryCode":26,"cosmosGeoPoint":43,"geoPoint":48,"contacts":49},"Bursa Uludag University Hospital","RECRUITING","Bursa","Nilüfer","16235","Turkey (Türkiye)",{"type":44,"coordinates":45},"Point",[46,47],29.06013,40.19559,{"lat":47,"lon":46},[50,56,61],{"name":51,"role":52,"phone":53,"phoneExt":54,"email":55},"Ali Haydar Colak, MD","CONTACT","+90 506 560 35 17","+902242954476","alihaydarcolak@uludag.edu.tr",{"name":57,"role":52,"phone":58,"phoneExt":59,"email":60},"Onur Alp, MD","+90 539 956 55 11","+902242953131","onuralp@uludag.edu.tr",{"name":62,"role":63,"phone":26,"phoneExt":26,"email":26},"Elif Basagan Mogol, Professor of Anesthesiology","PRINCIPAL_INVESTIGATOR",{"type":63,"investigatorFullName":65,"investigatorTitle":66,"investigatorAffiliation":5,"oldNameTitle":26,"oldOrganization":26},"Ali Haydar Çolak","Anesthesiology Resident","100627745","comparison-of-the-efficacy-of-combined-transversus-thoracic-plane-block-and-serratus-anterior-plane-block-versus-erector-spinae-plane-block-in-the-management-of-sternotomy-pain-100627745",false,"NCT07452627","Comparison of the Efficacy of Combined Transversus Thoracic Plane Block and Serratus Anterior Plane Block Versus Erector Spinae Plane Block in the Management of Sternotomy Pain","STERNOTOMİ AĞRISININ YÖNETİMİNDE TRANSVERSUS TORASİK PLAN BLOK VE SERRATUS ANTERİOR PLAN BLOK KOMBİNASYONU İLE EREKTÖR SPİNA PLAN BLOK ETKİNLİĞİNİN KARŞILAŞTIRILMASI","Inclusion Criteria:\n\n* Patients aged between 18 and 80 years.\n* Patients with American Society of Anesthesiologists (ASA) physical status I, II, or III.\n* Patients who provide written informed consent.\n* Patients scheduled for cardiac surgery via elective sternotomy.\n\nExclusion Criteria:\n\n* Pregnancy or suspected pregnancy\n* Body Mass Index (BMI) \\> 35 kg\u002Fm²\n* History of allergy to local anesthetics or opioids\n* Suspected coagulopathy or infection at the injection site\n* Severe neurological, psychiatric, hepatic, or renal failure","ALL","18 Years","80 Years",{"count":78,"type":79},50,"ESTIMATED","INTERVENTIONAL",[82],"NA","Background and Purpose: Median sternotomy is the standard surgical approach for cardiac procedures, yet it is associated with significant postoperative pain. Inadequate pain management can lead to pulmonary complications and chronic pain syndromes. While opioids are a cornerstone of multimodal analgesia, their side effects-such as sedation, respiratory depression, and nausea-can delay recovery. Furthermore, neuraxial techniques like epidural analgesia are often avoided in cardiac surgery due to the risks associated with systemic heparinization. This study aims to compare the efficacy of two non-neuraxial regional anesthesia techniques: the combination of Transversus Thoracic Plane Block (TTPB) and Serratus Anterior Plane Block (SAPB) versus the Erector Spinae Plane Block (ESPB).\n\nStudy Design and Population: This prospective, randomized study includes 50 patients (ASA I-III, aged 18-80) undergoing elective cardiac surgery via median sternotomy. Patients are randomized into two groups:\n\nTTPB + SAPB Group: Patients receive ultrasound-guided blocks targeting the anterior and lateral chest wall.\n\nESPB Group: Patients receive ultrasound-guided blocks targeting the paravertebral and intercostal spaces from a posterior approach.\n\nIntervention and Procedures: Following standardized anesthesia induction and invasive monitoring, the respective blocks are performed under ultrasound guidance. Intraoperative hemodynamic data are recorded at key surgical stages (incision, sternotomy, CPB). In the postoperative period in the intensive care unit (ICU), all patients will receive a standardized multimodal analgesia protocol including intravenous (IV) paracetamol and IV tenoxicam. While patients are intubated, pain will be assessed using the Behavioral Pain Scale (BPS). If the BPS score is above 3, IV fentanyl will be administered as rescue analgesia.\n\nFollowing extubation, pain levels will be evaluated using the Visual Analog Scale (VAS) at rest and during coughing at specific time points (0, 1, 2, 4, 8, 12, 16, and 24 hours). If the post-extubation VAS score is 4 or higher, intramuscular meperidine will be given as rescue analgesia. Additionally, IV ondansetron will be administered in case of nausea or vomiting. The study will also evaluate the time to extubation, time to clinical transport, and patient\u002Fsurgeon satisfaction using a 5-point Likert scale.\n\nPrimary and Secondary Outcomes:\n\nThe primary objective of this study is to compare postoperative pain intensity between the study groups using the Visual Analog Scale (VAS) (0-10) and the Behavioral Pain Scale (BPS) (3-12).\n\nSecondary objectives include:\n\nOpioid Consumption: Comparison of total intraoperative and postoperative opioid (IV fentanyl and IM meperidine) consumption within the first 24 hours.\n\nRecovery Milestones: Measurement of time to extubation, time to first mobilization, and time to clinical transport to the surgical ward.\n\nClinical Satisfaction and Safety: Assessment of patient and surgeon satisfaction using a 5-point Likert scale, and monitoring the incidence of opioid-related side effects, specifically postoperative nausea and vomiting (PONV) requiring ondansetron.\n\nExpected Impact:\n\nBy identifying the most effective regional anesthesia technique (TTPB+SAPB vs. ESPB) in conjunction with a standardized multimodal analgesia protocol (IV paracetamol and tenoxicam), this study seeks to maximize postoperative pain control and patient comfort. The results aim to achieve superior analgesia with lower pain scores, thereby facilitating earlier mobilization, reducing the incidence of postoperative complications, and enhancing the overall recovery process for patients undergoing cardiac surgery via median sternotomy. This approach ultimately contributes to the development of more effective, pain-centered recovery protocols in the intensive care unit.",[85,86,87,88],"Postoperative Pain","Sternotomy","Nerve Block","Patient Outcome Assessment",[90,91,92,93,94,95],"Transversus Thoracic Plane Block","Serratus Anterior Plane Block","Erector Spinae Plane Block","Sternotomy Pain","Cardiac Surgery","Multimodal Analgesia","2026-03-06",{"date":98,"type":99},"2026-03-10","ACTUAL",{"date":101,"type":99},"2025-12-01",{"date":103,"type":79},"2026-12",{"name":5,"class":6},1]