Bilateral parasternal and rectus sheath blocks reduce pain post-cardiac surgery: a pilot trial.

Objective: This study aimed to investigate the effects of ultrasound-guided bilateral parasternal block (PSB) combined with rectus sheath block (RSB) on postoperative recovery quality in patients undergoing median sternotomy for cardiac surgery.

Methods: Eighty patients were randomly assigned to either the intervention group (receiving PSB + RSB,  = 40) or the control group (not receiving PSB + RSB,  = 40). The primary outcome was opioid consumption within the first 24 h postoperatively. Secondary outcomes included Visual Analog Scale (VAS) pain scores and various surgery and recovery-related parameters.

Results: The intervention group showed significantly reduced opioid consumption in the first 24 h postoperatively compared to the control group ( < 0.05), though no significant difference was observed at 48 h postoperatively. VAS pain scores at extubation and at 12, 24, and 48 h post-extubation were significantly lower in the intervention group ( < 0.05). The intervention group also demonstrated superior Quality of Recovery-15 (QoR-15) scores at all observed time points compared to the control group ( < 0.05), with no block-related adverse events. There were no significant differences in surgical and recovery-related parameters between the groups.

Conclusion: Ultrasound-guided bilateral PSB combined with RSB effectively enhances postoperative analgesia and the quality of recovery in patients undergoing median sternotomy for cardiac surgery. The application of ultrasound-guided bilateral parasternal block combined with rectus sheath block in median sternotomy cardiac surgery offers a new pain management strategy that is both safe and highly effective. This approach reduces postoperative analgesic requirements and improves recovery quality for cardiac surgery patients.

Clinical Trial Registration: https://www.chictr.org.cn/showproj.html?proj=180456, China Clinical Trial Registry (ChiCTR2200064733).