Comparison of the effect of preoperative or postoperative parasternal block on the analgesic need in the first 24 hours in patients who underwent cardiac surgery with median sternotomy

ABSTRACT
 Aim: Our aim is to compare the application of parasternal block before and after the operation in terms of postoperative sternum pain, opioid need, complications, extubation time and ease of application of the block in patients undergoing cardiac surgery with median sternotomy.
Materials and Methods: The study is single-center, observational and retrospective. 40 patients who underwent preoperative parasternal block (N=20) and postoperative parasternal block (n=20) were included in the study. All patients were tracheally intubated with intravenous midazolam (0.05-0.1 mg/kg), fentanyl (2-5 μ/kg IV ), propofol (1-2 mg/kg), rocuronium (1 mg/kg). Anesthesia maintenance was provided with sevoflurane (MAC 1), O2/air (FIO2 0.40), fentanyl (2–5 μ/kg/h) and rocuronium (0.2–0.4 mg/kg). Patients in the preoperative group received a block before surgery. The other group received a block after the surgery was completed.
Results: 40 patients who underwent the same block in the preoperative and postoperative periods were included in the study. There was no significant difference between the two groups in which preoperative parasternal block and postoperative parasternal block were performed in terms of age, gender, comorbidities, ASA scoring and operation time. The files of the patients in the groups were evaluated in terms of pain, opioid need, extubation time and development of complications during the intensive care unit process.. Conclusion: As a result, performing parasternal block before or at the end of surgery does not have a significant effect on the time of onset of sternum pain, opioid need, occurrence of complications and extubation time. However, whether the block is performed preoperatively or postoperatively has an effect on the duration of the block.
Keywords: Parasternal block, cardiac surgery, sternum pain