Efficacy of ultrasound-guided transversus thoracic muscle plane block on postoperative opioid consumption after cardiac surgery: a prospective, randomized, double-blind study

Abstract Objectives The postoperative analgesic efficacy of transversus thoracic muscle plane block (TTMPB) has not yet been evaluated sufficiently. This randomized controlled study evaluated the effect of TTMPB on postoperative opioid consumption in patients undergoing open heart surgery. Design Prospective, randomized, double-blind study Settings Single institution, academic university hospital. Participants Forty-eight adult patients having cardiac surgery with median sternotomy. Interventions Patients were randomly assigned to receive preoperative ultrasound-guided TTMPB with either 20 ml 0.25% bupivacaine or saline bilaterally. Postoperative analgesia was performed intravenously in the two groups four times a day with paracetamol 1000 mg and patient-controlled analgesia with fentanyl. Measurements and Main Results The primary outcome was opioid consumption at first 24 hours. Secondary outcomes included postoperative pain scores, first analgesic requirement time, rescue analgesia, intensive care discharge time and side effects. Compared with the control group (median 465 mcg, IQR 415-585), TTMP group (median 255 mcg, IQR 235-305) reduced postoperative 24-hour opioid consumption (p Conclusions A single preoperative injection of TTMPB provided effective analgesia and decreased opioid requirements in patients undergoing open heart surgery.