The Benefit of Local Anesthesia at the Sternum in Patients With Coronary Surgery
Status:
Completed
Trial end date:
2019-11-07
Target enrollment:
Participant gender:
Summary
Patients undergoing coronary artery bypass grafting are at risk for perioperative myocardial
ischemia. Episodes of tachycardia and hypertension, which are associated with an increase in
myocardial oxygen consumption, are predictive events of these ischemia.
During cardiac surgery by sternotomy, some maneuvers, e.g. intubation, skin incision,
sternotomy and cannulation, may be associated with tachycardia and/or increases in blood
pressure despite an adequate level of anesthesia. Usually these episodes are controlled by
the administration of a high-dose of anesthetic agents.
The parasternal block, by bolus or continuous infusion through a single catheter, showed its
effectiveness on postoperative pain after sternotomy. It allows a blocking of anterior
branches of intercostal nerves at the lateral edge of the sternum; branches in charge of
innervation of the sternum and the overlying skin surface.
The preoperative parasternal block, once general anesthesia performed, could provide an
effective level of locoregional anesthesia of the chest wall, thus limiting the occurrence of
episodes of tachycardia and / or hypertension without having to resort to massive doses of
anesthetic agents during sternotomy in patients undergoing coronary bypass surgery.