Ultrasound-guided pecto-intercostal fascial plane block for chronic postoperative pain after cardiac surgery via...

Median sternotomy As per our journal style, article titles should not include capitalised letters unless these are proper nouns/acronyms. We have therefore used the article title "Ultrasound-guided Pecto-intercostal fascial plane block for chronic postoperative pain after cardiac surgery via median sternotomy: study protocol for a randomized controlled trial" as opposed to "Ultrasound-guided Pecto-intercostal Fascial Plane Block for Chronic Postoperative Pain after Cardiac Surgery via Median Sternotomy: study protocol for a randomized controlled trial". Please check if this is correct.remains the preferred incision technique for cardiac surgery. Consequently, postoperative pain is a prevalent complication following such procedures, potentially leading to delayed recovery and a diminished quality of life for patients. The parasternal intercostal fascial plane block (PIFPB) is a superficial regional anesthetic technique targeting the interfacial plane between the pectoralis major and internal intercostal muscles. Currently, no randomized controlled trials have evaluated the impact of PIFPB on chronic pain following cardiac surgery via median sternotomy. To address this knowledge gap, we conducted a prospective, randomized, double-blind, placebo-controlled trial specifically designed to evaluate the effect of preoperative PIFPB on chronic pain incidence in patients undergoing median sternotomy for cardiac surgery.

This study protocol has been approved by the Ethics Review Committee of Zhongda Hospital, Southeast University. We plan to enroll 304 adult patients scheduled for cardiac surgery via median sternotomy under general anesthesia. Participants will be randomly allocated to one of two groups: the PIFPB group will receive a single injection of 40 ml of 0.375% ropivacaine hydrochloride administered, while the control group will receive an equivalent volume of 0.9% saline placebo. The primary outcome is the incidence of chronic pain at 3 months post-surgery.

This is a novel randomized controlled trial designed to evaluate the impact of preoperative ultrasound-guided single parasternal intercostal fascia plane block on the incidence of chronic post-surgical pain (CPSP) in patients undergoing cardiac surgery via median sternotomy. The study will comprehensively describe the severity of postoperative acute and chronic pain, as well as associated clinical outcomes, in this patient population. Our findings may provide a foundation for optimizing analgesic strategies in cardiac surgery via median thoracotomy, further elucidate the role of regional anesthesia in postoperative chronic pain development, and ultimately improve postoperative quality of life for these patients.

The trial protocol was prospectively registered with the China Clinical Trial Registry on June 16, 2025, (trial identifier: ChiCTR2500104378).