CLINICAL TRIAL

Parasternal blocks for Coronary Artery Bypass Grafting (CABG)

Recruiting · 18+ · All Sexes · Montreal, Canada

Long-acting Parasternal Blocks for Analgesia After Cardiac Surgery

See full description

About the trial for Coronary Artery Bypass Grafting (CABG)

Treatment Groups

This trial involves 2 different treatments. Parasternal Blocks is the primary treatment being studied. Participants will all receive the same treatment. Some patients will receive a placebo treatment. The treatments being tested are in Phase 3 and have had some early promising results.

Main TreatmentA portion of participants receive this new treatment to see if it outperforms the control.
Parasternal blocks
DRUG
Control TreatmentAnother portion of participants receive the standard treatment to act as a baseline.
Standard of care
DRUG

Eligibility

This trial is for patients born any sex aged 18 and older. There is one eligibility criterion to participate in this trial as listed below.

Inclusion & Exclusion Checklist
Mark “yes” if the following statements are true for you:
Patients coming for elective and urgent coronary artery bypass (CABG)-only surgery.
View All
Odds of Eligibility
Unknown<50%
Be sure to apply to 2-3 other trials, as you have a low likelihood of qualifying for this one.Apply To This Trial
Similar Trials

Approximate Timelines

Please note that timelines for treatment and screening will vary by patient
Screening: ~3 weeks
Treatment: varies
Reporting: From ICU arrival until first ambulation (approximately first 72 hours postoperatively)
This trial has approximate timelines as follows: 3 weeks for initial screening, variable treatment timelines, and reporting: From ICU arrival until first ambulation (approximately first 72 hours postoperatively).
View detailed reporting requirements
Trial Expert
Connect with the researchersHop on a 15 minute call & ask questions about:
- What options you have available- The pros & cons of this trial
- Whether you're likely to qualify- What the enrollment process looks like

Measurement Requirements

This trial is evaluating whether Parasternal blocks will improve 1 primary outcome, 10 secondary outcomes, and 9 other outcomes in patients with Coronary Artery Bypass Grafting (CABG). Measurement will happen over the course of From ICU arrival until first mobilization (approximately first 48 hours postoperatively).

Mobilization
FROM ICU ARRIVAL UNTIL FIRST MOBILIZATION (APPROXIMATELY FIRST 48 HOURS POSTOPERATIVELY)
Time from ICU arrival to the first mobilization to a chair
Intensive Care Unit (ICU) Length of Stay
FROM SURGERY UNTIL DISCHARGE FROM THE ICU, ASSESSED FROM THE DATE OF SURGERY UP UNTIL 6 MONTHS AFTER THE COMPLETION OF THE STUDY
Time spent in the intensive care unit after surgery (days)
Hospital Length of Stay
FROM THE DATE OF SURGERY UP UNTIL DISCHARGE FROM HOSPITAL, FOLLOWED FROM THE DATE OF SURGERY UP UNTIL 6 MONTHS AFTER THE COMPLETION OF THE STUDY
Time spent in the hospital after surgery (days)
Sternal pain at 3 months
THREE MONTHS AFTER THE DAY OF SURGERY
Persistent pain at the sternum
Narcotic prescription on discharge
UPON DISCHARGE FROM HOSPITAL AFTER SURGERY (APPROXIMATELY 1 WEEK AFTER SURGERY)
Having a narcotic prescription on discharge
Pain score with inspirometry
12 AND 48 HOURS AFTER SURGERY
Visual analog scale (VAS) pain score from the sternotomy site during inspirometry. The VAS score is a scale from 0 to 10 where 0 is equivalent to "no pain" and 10 is equal to "the worst imaginable pain"
See More

Who is running the study

Principal Investigator
M. C.
Prof. Matthew Cameron, Assistant Professor
Jewish General Hospital

Patient Q & A Section

Please Note: These questions and answers are submitted by anonymous patients, and have not been verified by our internal team.

What causes coronary artery bypass grafting (cabg)?

The incidence of coronary artery bypass grafting in Saudi Arabia has been increasing in the recent years. The reasons for this development can be attributed to increasing life expectancy and improvements in the treatment of risk-factor-based diseases across different age groups. Furthermore, this procedure can be applied in Saudi Arabia when the procedure is warranted.

Anonymous Patient Answer

How many people get coronary artery bypass grafting (cabg) a year in the United States?

The American College of Cardiology (ACC) estimates there will be 1,070,000 angioplasty-driven CABG and 1,834,000 coronary artery bypass surgery (CABG) operations performed in the Unites States each year (approximately 3.3 per 1,000 inhabitants). The ACC estimate 3.1 per 1,000 inhabitants per year for uncomplicated percutaneous coronary intervention (PCI) and 9.4 per 1,000 for complicated PCI. In the ACC estimates, 93% of new PCI patients are white, 3% black, and 0.2% other races.

Anonymous Patient Answer

Can coronary artery bypass grafting (cabg) be cured?

Cardiac rehabilitation does not reduce mortality in patients who underwent primary coronary artery bypass grafting. If patients received good medical therapy postoperatively, they are not expected to have a poorer survival. To reduce late mortality after primary bypass grafting at this facility it appears reasonable to recommend postoperative cardiac rehabilitation in patients at risk to increase risk of death.

Anonymous Patient Answer

What is coronary artery bypass grafting (cabg)?

To achieve the best possible result after cardiac surgery, the surgeon and patient need to work together and make individual decisions about the best type of surgery for a given patient's age and condition. Although surgeons are still debating the appropriateness of the timing for revascularization, a current consensus suggests that in those with single vessel disease and less severe symptoms, cardiologists should be permitted to perform the operation at the time the patient is most comfortable with surgery. However, further research is necessary to confirm these conclusions with greater patient numbers, and longer follow-up sessions. The best ways to increase the patient's comfort and to improve the outcome will need to be developed.

Anonymous Patient Answer

What are the signs of coronary artery bypass grafting (cabg)?

We summarize the diagnostic history and physical examination findings of patients with coronary artery bypass grafting, as well as the appropriate treatment plans for this patient population. These include evaluation for heart attack, hypertension, coronary artery disease, cardiac disease, and heart failure.

Anonymous Patient Answer

What are common treatments for coronary artery bypass grafting (cabg)?

Some patients will require additional procedures to strengthen the heart's circulation after the bypass. For less urgent cases, treatment may be directed toward improving symptoms and reducing other cardiovascular problems associated with coronary artery disease.

Anonymous Patient Answer

Is parasternal blocks typically used in combination with any other treatments?

The most commonly used methods for treating postinjury chest pain during the first week after surgery were parasternal blocks. A majority of patients had the additional treatment of rib fractures requiring a chest tube. The timing of chest tube placement is controversial, but rib fractures are rare in patients without chest tube placement within the first three days after initial surgery.

Anonymous Patient Answer

How does parasternal blocks work?

Findings from a recent study show that [parasternal chest wall block with 0.5% ropivacaine, 0.25 mg/kg, and 2 cc of normal saline] provides equivalent analgesia to [parasternal block with 0.5% ropivacaine, 0.25 mg/kg, and 10 cc of normal saline] and [general paraxial block]. The addition of normal saline to 0.5% ropivacaine with 0.25 mg/kg is effective in relieving postoperative chest pain in patients undergoing coronary artery bypass graft.

Anonymous Patient Answer

What does parasternal blocks usually treat?

Compared to the other techniques, the parasternal block does not cause any major adverse effects. It is a safe and effective local anesthetic block in a complex setting like open heart surgery, with no additional risks on the patients health.

Anonymous Patient Answer

How serious can coronary artery bypass grafting (cabg) be?

There may be significant risks associated with the procedure, and many factors are involved that may affect outcome. Older patients, those with higher bleeding rates and those having more severe obstructions are at relatively higher risk for these complications, especially inpatient death and the need for further interventions. Some of the more common complications are: sternal dehiscence, wound infections, mediastinal leakage of infected sutures, prolonged postoperative mechanical ventilation and cardiac arrest. We think that a proper explanation of these risks to the patient is of first importance before surgery, and we urge patients to have periodic visits to the cardiac surgeons for evaluation.

Anonymous Patient Answer

Who should consider clinical trials for coronary artery bypass grafting (cabg)?

There is no good evidence to support the hypothesis that CABG can be safely performed on patients with significant comoralities, risk factors for death or MI after adjustment. A reasonable proportion (4%) of patients undergoing CABG in our tertiary center had comorbities that, as defined in trial trials, have a very high risk of death or MI. The benefit of participating in such trials should be weighed carefully in the context of risks and cost.

Anonymous Patient Answer

Has parasternal blocks proven to be more effective than a placebo?

Results from a recent paper of this study do not support the use of parasternal injection of 0.125% bupivacaine to reduce intraoperative chest tube drainage in patients undergoing off-pump coronary artery bypass grafting.

Anonymous Patient Answer
See if you qualify for this trial
Get access to this novel treatment for Coronary Artery Bypass Grafting (CABG) by sharing your contact details with the study coordinator.