Effectiveness of Pecto-Intercostal Fascia Plane Block in Reducing Total Postoperative Opioid Consumption in Cardiac Surgery Involving Sternotomy: A Meta-Analysis
Abstract
Abstract: The pecto-intercostal fascia plane block (PIFB) is gaining recognition for its potential to reduce postoperative opioid use after cardiac surgery. This study aimed to evaluate the effectiveness of PIFB compared with conventional intravenous regimens in reducing total postoperative opioid consumption in patients undergoing cardiac surgery involving sternotomy. A meta-analysis of relevant studies, published up to August 13, 2024, retrieved from the PubMed and CENTRAL databases was performed. The inclusion criteria were studies involving a superficial parasternal block or PIFB for patients undergoing cardiac surgery involving sternotomy. Studies comparing PIFB with other blocks or local anesthetic regimens were excluded. Data analysis was performed using an inverse variance random-effects model using RevMan 5.4.1 software, with the effect measure expressed as standardized mean difference (SMD) to account for the different opioids used. Of 88 studies retrieved in the literature search, 16 fulfilled the inclusion criteria [ten ultrasound (US)-guided and six non-US-guided]. PIFB significantly reduced total opioid consumption [SMD -1.55 (95% CI -2.15 to -0.95); P < 0.001] and time to extubation [SMD -1.22 (95% CI -2.05 to -0.38); P < 0.001]. A subgroup analysis of multiple- versus single-shot injections yielded consistent results. Analyses including only US-guided PIFB revealed consistent reductions in total opioid consumption [SMD -1.18 (95% CI -1.79 to -0.56); P <…
How strong is the evidence?
Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid.
Read the paper
Related studies
- Effect of dexamethasone as an analgesic adjuvant to multimodal pain treatment after total knee arthroplasty: randomised clinical trial
- Effect of a Postoperative Multimodal Opioid-Sparing Protocol vs Standard Opioid Prescribing on Postoperative Opioid Consumption After Knee or Shoulder Arthroscopy: A Randomized Clinical Trial
- Comparison of the Post-Caesarean Analgesic Effect of Adding Dexmedetomidine to Paracetamol and Ketorolac: A Randomized Clinical Trial
- A triple-blind randomized clinical trial of different associations between dexamethasone and non-steroids anti-inflammatories for preemptive action in third molar extractions
- An open label randomized clinical trial of Indomethacin for mild and moderate hospitalised Covid-19 patients
- Oral paracetamol and/or ibuprofen for treating pain after soft tissue injuries: Single centre double-blind, randomised controlled clinical trial
Go deeper in Evidence Hub
Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.