{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T11:40:08Z","timestamp":1784634008126,"version":"3.55.0"},"reference-count":28,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,2,20]],"date-time":"2025-02-20T00:00:00Z","timestamp":1740009600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Surg."],"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>This study aimed to investigate the effects of ultrasound-guided bilateral parasternal block (PSB) combined with rectus sheath block (RSB) on postoperative recovery quality in patients undergoing median sternotomy for cardiac surgery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Eighty patients were randomly assigned to either the intervention group (receiving PSB\u2009+\u2009RSB, <jats:italic>n<\/jats:italic>\u2009=\u200940) or the control group (not receiving PSB\u2009+\u2009RSB, <jats:italic>n<\/jats:italic>\u2009=\u200940). The primary outcome was opioid consumption within the first 24\u2005h postoperatively. Secondary outcomes included Visual Analog Scale (VAS) pain scores and various surgery and recovery-related parameters.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The intervention group showed significantly reduced opioid consumption in the first 24\u2005h postoperatively compared to the control group (<jats:italic>P<\/jats:italic>\u2009&amp;lt;\u20090.05), though no significant difference was observed at 48\u2005h postoperatively. VAS pain scores at extubation and at 12, 24, and 48\u2005h post-extubation were significantly lower in the intervention group (<jats:italic>P<\/jats:italic>\u2009&amp;lt;\u20090.05). The intervention group also demonstrated superior Quality of Recovery-15 (QoR-15) scores at all observed time points compared to the control group (<jats:italic>P<\/jats:italic>\u2009&amp;lt;\u20090.05), with no block-related adverse events. There were no significant differences in surgical and recovery-related parameters between the groups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Ultrasound-guided bilateral PSB combined with RSB effectively enhances postoperative analgesia and the quality of recovery in patients undergoing median sternotomy for cardiac surgery. The application of ultrasound-guided bilateral parasternal block combined with rectus sheath block in median sternotomy cardiac surgery offers a new pain management strategy that is both safe and highly effective. This approach reduces postoperative analgesic requirements and improves recovery quality for cardiac surgery patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Clinical Trial Registration<\/jats:title><jats:p><jats:uri>https:\/\/www.chictr.org.cn\/showproj.html?proj=180456<\/jats:uri>, China Clinical Trial Registry (ChiCTR2200064733).<\/jats:p><\/jats:sec>","DOI":"10.3389\/fsurg.2025.1526890","type":"journal-article","created":{"date-parts":[[2025,2,20]],"date-time":"2025-02-20T06:37:59Z","timestamp":1740033479000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":4,"title":["Bilateral parasternal and rectus sheath blocks reduce pain post-cardiac surgery: a pilot trial"],"prefix":"10.3389","volume":"12","author":[{"given":"Yangsi","family":"Huang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chengdi","family":"Ouyang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fang","family":"He","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu","family":"Zhong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guofeng","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yizhi","family":"Lu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yanhua","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,2,20]]},"reference":[{"key":"B1","first-page":"32","article-title":"Manubrium-sparing median sternotomy as a uniform approach for cardiac operations","volume":"27","author":"Choi","year":"2000","journal-title":"Tex Heart Inst J"},{"key":"B2","doi-asserted-by":"publisher","first-page":"863","DOI":"10.1093\/icvts\/ivaa040","article-title":"A randomized trial comparing the effects of sternal band and plate fixation of the sternum with that of figure-of-8 wires on sternal edge motion and quality of recovery after cardiac surgery","volume":"30","author":"Royse","year":"2020","journal-title":"Interact Cardiovasc Thorac Surg"},{"key":"B3","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1007\/s11916-017-0607-y","article-title":"Multimodal analgesia, current concepts, and acute pain considerations","volume":"21","author":"Helander","year":"2017","journal-title":"Curr Pain Headache Rep"},{"key":"B4","doi-asserted-by":"publisher","first-page":"691","DOI":"10.1001\/jamasurg.2017.0898","article-title":"Postoperative multimodal analgesia pain management with nonopioid analgesics and techniques: a review","volume":"152","author":"Wick","year":"2017","journal-title":"JAMA Surg"},{"key":"B5","doi-asserted-by":"publisher","first-page":"8","DOI":"10.1111\/anae.15256","article-title":"The role of regional anaesthesia and multimodal analgesia in the prevention of chronic postoperative pain: a narrative review","volume":"76","author":"Chen","year":"2021","journal-title":"Anaesthesia"},{"key":"B6","doi-asserted-by":"publisher","first-page":"1128691","DOI":"10.3389\/fsurg.2023.1128691","article-title":"Effect of pecto-intercostal fascial block on extubation time in patients undergoing cardiac surgery: a randomized controlled trial","volume":"10","author":"Wang","year":"2023","journal-title":"Front Surg"},{"key":"B7","doi-asserted-by":"publisher","first-page":"3729","DOI":"10.1111\/jocs.16882","article-title":"Median sternotomy pain after cardiac surgery: to block, or not? 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