[Preliminary clinical study on intrusion of overerupted molars with a removable appliance].

PURPOSE: Transversus thoracic muscle plane block (TTPB) is an upcoming modality for analgesia post-sternotomy. We aimed to evaluate the effect of pre-operative TTPB on post-operative analgesia in cardiac surgical patients undergoing sternotomy.

METHODS

Seventy patients (18-65 years) of either gender, posted for cardiac surgery needing midline sternotomy, were prospectively enrolled and block randomized into two groups of 35 each -group T (receiving TTPB) and group C (control). Post-operative analgesia was monitored using the Numerical Rating Scale (NRS) during rest, cough, and incentive spirometry. Diaphragmatic excursion and arterial blood gases (ABG) were used to measure post-operative respiratory function, along with total opioid consumption and the duration of post-operative mechanical ventilation.

RESULTS

NRS at rest, during cough and spirometry was significantly lower in group T at 6, 12, and 24 h post-surgery (p < 0.0001). Bilateral diaphragmatic excursion (at rest and maximal inspiration) was reduced more in group C than group T (p < 0.0001 at 12 h and 24 h post-operatively). Mean opioid consumption in the first 24 h after surgery was much lesser in group T (232.29 µg vs 373 µg, p < 0.0001), along with a lesser need for rescue analgesia in the same group. The mean duration of mechanical ventilation was 9.31 h in group T and 11.53 h in group C (p < 0.0001).

CONCLUSION

Administering TTPB prior to midline sternotomy in cardiac surgeries is an effective way of providing post-operative analgesia. It also improves the diaphragmatic excursion, reduces opioid consumption, and aids in faster extubation.

TRIAL REGISTRATION: The study has been registered with the Clinical Trials Registry of India prior to patient enrolment.(CTRI/2022/10/046536).Link to webpage- https://ctri.nic.in/Clinicaltrials/regtrial.php?trialid=75409&EncHid=13705.55824&modid=1&compid=19 Date of registration: 17/10/2022.Date of first patient enrollment: 21/10/2022.

SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s12055-025-02015-5.