Background and Aims: Post-sternotomy pain management remains a key concern in adult cardiac surgery. This study evaluated the efficacy and safety of ropivacaine infiltration via a presternal multi-orifice catheter for postoperative analgesia. Design: A prospective randomized controlled trial. Setting: A single tertiary care center. Material and Methods: A total of 175 adult patients undergoing cardiac surgery via median sternotomy were randomized into three groups: Group A ( n = 58): Received 0.375% ropivacaine as continuous infusion at 5 mL/hour, Group B ( n = 58): Received 5 mL of 0.375% ropivacaine as intermittent boluses every 8 hours, and Group C ( n = 59): Received conventional intravenous tramadol. Pain was assessed using the visual analogue scale (VAS) for 48 hours post-extubation. Intravenous tramadol was used as rescue analgesia if VAS≥3. Results: Group B reported significantly lower VAS scores and rescue tramadol requirements (56 ± 35 mg) compared to Group A (155 ± 32 mg) and Group C (135 ± 45 mg). No significant differences were observed among the groups regarding hemodynamic parameters, catheter-related infections, time to extubation, or intensive care unit (ICU) stay. Conclusion: Presternal infiltration of 0.375% ropivacaine is safe and effective for post-sternotomy analgesia. The intermittent bolus technique provides superior pain relief and reduces opioid consumption compared to continuous infusion and standard intravenous analgesia.
Swetha et al. (Thu,) studied this question.