{
  "abstract": "Background:: Ultrasound-guided facial plane blocks are central to enhanced recovery after cardiac surgery (ERACS) protocols, yet evidence comparing pecto-intercostal facial plane block (PIFB) and transversus thoracic facial plane block (TTPB) with rectus sheath block (RSB) remains limited.\n\nMethods:: This prospective, randomized, controlled trial enrolled 100 adult patients (ASA II–III) undergoing elective median sternotomy at a tertiary care hospital in South India. Patients received standardized general anesthesia and were randomized to bilateral PIFB or TTPB (20 mL 0.25% bupivacaine + 4 mg dexamethasone per side) with RSB after cardiopulmonary bypass. The primary outcome was 24-hour postoperative fentanyl consumption. Secondary outcomes included visual analog scale (VAS) pain scores at 0, 3-, 6-, 12-, and 24-hours post-extubation, rescue analgesia, extubation timing, ICU/hospital stay, and complications.\n\nResults:: A total of 96 patients completed analysis (PIFB: n = 47; TTPB: n = 49). Mean 24-hour fentanyl consumption was 267.23 ± 92.54 µg (PIFB) vs 297.18 ± 88.09 µg (TTPB), mean difference − 29.95 µg (95% confidence interval: −66.60 to 6.70; P = 0.108). VAS scores showed no significant between-group differences (P > 0.05). Rescue analgesia rates were similar, with 84% and 90% not requiring additional opioids. Four PIFB patients (8%) stayed intubated >24 hours due to cardiac issues, vs none in the TTPB group (P = 0.121).\n\nConclusion:: This trial found no significant difference in opioid consumption or pain scores between PIFB + RSB and TTPB + RSB for post-sternotomy analgesia. Both techniques were safe within ERACS protocols. Larger noninferiority trials are needed before establishing equivalence or recommending one technique over another.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Anaesthesiology and Critical Care, ESIC Medical College and Super Speciality Hospital, Sanathnagar, Hyderabad, Telangana, India"
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 7,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Priya Gupta"
    },
    {
      "affs": [
        0
      ],
      "name": "Ravikanth Pula"
    },
    {
      "affs": [
        0
      ],
      "name": "Venu Polapally"
    },
    {
      "affs": [
        0
      ],
      "name": "Sunanda Gooty"
    },
    {
      "affs": [
        0
      ],
      "name": "Varsha Krosuri"
    },
    {
      "affs": [
        0
      ],
      "name": "Nagarjuna Thakur"
    },
    {
      "affs": [
        0
      ],
      "name": "Ramachandran Gopinath"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/1hkjh1j9033x5.bib",
  "cited_by": 1,
  "doi": "10.4103/aca.aca_112_26",
  "fulltext_url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC13743091/",
  "id": "1hkjh1j9033x5",
  "issns": [
    "0971-9784",
    "0974-5181"
  ],
  "landing_url": "https://doi.org/10.4103/aca.aca_112_26",
  "language": "en",
  "licence": "CC-BY-NC-SA-4.0",
  "licence_label": "CC BY-NC-SA 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc-sa/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Original Article"
    ],
    [
      "openalex",
      "2703|Anesthesia and Pain Management"
    ]
  ],
  "openalex": "W7221503538",
  "pdf_url": null,
  "pmcid": "PMC13743091",
  "pmid": "42862674",
  "published": "2026-10-12",
  "publisher": "Wolters Kluwer -- Medknow Publications",
  "ris": "https://research.draconitic.com/paper/1hkjh1j9033x5.ris",
  "sources": [
    {
      "first_seen": "2026-11-10T12:23:49Z",
      "native_id": "PMC13743091",
      "source": "pmc",
      "url": "https://doi.org/10.4103/aca.aca_112_26"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2703|Anesthesia and Pain Management",
      "subfield": "surgery"
    }
  ],
  "title": "Comparative Efficacy of Pecto-Intercostal Facial Plane Block vs Transversus Thoracic Facial Plane Block Combined with Rectus Sheath Block for Post-Sternotomy Analgesia: A Prospective Randomized Controlled Trial",
  "title_text": "Comparative Efficacy of Pecto-Intercostal Facial Plane Block vs Transversus Thoracic Facial Plane Block Combined with Rectus Sheath Block for Post-Sternotomy Analgesia: A Prospective Randomized Controlled Trial",
  "type": "peer-reviewed",
  "updated_at": "2026-11-10T12:23:49Z",
  "url": "https://research.draconitic.com/paper/1hkjh1j9033x5",
  "venue": "Annals of Cardiac Anaesthesia",
  "versions": []
}