The effect of ultrasound guided pecto-intercostal fascial plane block with levobupivacaine on extubation time after on pump coronary artery bypass grafting surgery: A randomised controlled trial

Background: To assess the effect of pecto-intercostal fascial plane block (PIFB) with Levobupivacaine after on-pump coronary artery bypass grafting (CABG) surgery on post-operative recovery. Methods: This randomised, double-blinded, parallel group, controlled, clinical trial enrolled 60 patients scheduled for elective on-pump CABG with PIFB. The patients were randomly allocated to either levobupivacaine local anaesthesia (LA) group receiving 30 ml of 0.25% levobupivacaine on two divided doses (15 ml for each side of the sternal border) or a placebo (P) group receiving 30 ml of saline in the same manner. Results: The primary outcome was time to extubation. Secondary outcomes included visual analog scale (VAS) scores at 0, 2, 4, 6, and 12 hours, total fentanyl consumption during intensive care unit (ICU) stay, and ICU and hospital length of stay (LOS). Time to extubation was significantly shorter in the LA group than in the control group (p = 0.027). VAS scores were significantly lower in the LA group at 0 and 2 hours post-extubation (p = 0.002 and p = 0.006, respectively). Total fentanyl consumption was lower in the LA group (p<0.001). ICU stay was shorter in the LA group (p = 0.035), as was hospital LOS (p = 0.013). Conclusion: PIFB significantly reduced extubation time, opioid consumption, and ICU/hospital LOS in patients undergoing on-pump CABG surgery.