Thoracic Surgery, Video-assisted, Postoperative Pain, Rachianesthesia, Sufentanil, Morphine
Conditions
Brief summary
The purpose of the study is to determine if the administration of a mix of Sufentanil and Morphine in intrathecal is a better analgesia regimen than PCA alone in patient post-VATS.
Detailed description
This study will compare the need for analgesia (Hydromorphone PCA) of two groups of patients post-VATS. The placebo group will only have a PCA for post-operative analgesia, witch is the standard care for patient post-VATS. The experimental group will have a intrathecal injection of a mix of morphine and sufentanil before the induction of anesthesia.
Interventions
DRUGIntrathecal Morphine/Sufentanil
DEVICEPCA
Sponsors
Université de Sherbrooke
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
TRIPLE (Subject, Caregiver, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to 75 Years
Healthy volunteers
No
Inclusion criteria
* VATS * ASA 1,2 or 3 * Minimum weight of 50 kg * Patient able to consent
Exclusion criteria
* Patient refusal * Patient unable to understand PCA * Contraindication to rachianalgesia * Zona * Pregnancy * Over 30 mg of morphine during the last 24 hours * Use of Pregabalin, Gabapentin, Doluxetin, Amitriptyline or NSAI in a context of chronic pain * Severe allergic reaction to morphine, hydromorphone, sufentanil or local anesthetic * Intubation over 1 hour after surgery (unability to use PCA) * High risk of conversion to thoracotomy * Unable to perform rachianalgesia due to technical difficulties
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Hydromorphone consommation | 24hr | The amount of Hydromorphone needed by the patient in the first 24hr after his VATS. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Pain | Every 4h x 24hr | A VAS will be used. |
| Adverse effects of narcotics | Every 4h x 24hr | Including : * Saturation \[Saturation (%) and the need for oxygen (l/min) will be assess to evaluate the incidence of desaturation and hypoventilation in both arms\] * Sedation \[Sedation will be evaluate with the Riker Sedation Agitation Scale\] * Respiratory rate \[To evaluate the incidence of hypoventilation (\<8/min) and to compare the average between both arms\] |
| Adverse reactions associate with rachianesthesia | 24hr | Including : * Backache * Headache * Legs strength |
| Adverse reactions of narcotics | 24hr | Including : * Nausea * Pruritis * Urinary retention |
Countries
Canada
Outcome results
None listed