TTP block under dynamic ultrasound guidance plus the standard care (hydromorphone, fentanyl, aspirin, acetaminophen)

Patients in the standard care group will receive pain medications, such as hydromorphone, fentanyl, aspirin and acetaminophen.

Postoperative Pain

Nerve Block

Cardiac Surgery

The investigator (RF or DV) will administer bilateral TTP block under dynamic ultrasound guidance with an echogenic needle using a total of 40mL of 0.5% ropivacaine (200mg), 20mL on each side. If the patient is less than 70kg, the total dose administered will be 40mL of 0.3% ropivacaine (150mg). The patient will not require sedation or analgesia for the performance of the block. The projected time for block completion is 20 minutes after appropriate patient positioning (supine) and exposure (upper chest). After block administration, the patient will be monitored for local anesthetics toxicity, hemodynamic instability, and allergic or unexpected adverse reactions for 20 minutes. Standard intensive care monitors are sufficient.

Transthoracic Transversus Plane Block

Hydromorphone Hydrochloride

Aspirin

Acetaminophen

Fentanyl

London Health Sciences Centre

Analgesic Effects of Transversus Thoracic Plane (TTP) Block in Cardiac Surgery

Analgesic Effects of Transversus Thoracic Plane (TTP) Block in Cardiac Surgery - Pilot Study

The amount of narcotics (hydromorphone or fentanyl) required will be assessed on patients' chart.

0 hour (the time of ICU admission) to extubation

Recruitment rate (Main outcome in the feasibility study, which will be conducted prior to the main study.)

Acceptability will be assessed using a likert scale questionnaire(Main outcome in the feasibility study, which will be conducted prior to the main study.)

hypercapnia/breast neoplasms

Analgesic Effects of Transversus Thoracic Plane (TTP) Block in Cardiac Surgery

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