Pain, Postoperative
Conditions
Keywords
Thoracic paravertebral block, Patient controlled analgesia, Video Assisted Thoracoscopic Surgery, Postoperative acute pain, Chronic pain
Brief summary
Video-assisted thoracoscopic surgeries (VATS) include severe postoperative acute pain which is also a predictor of chronic pain. In this study, the investigators aim to compare the postoperative effects of thoracic paravertebral block (TPVB) and intravenous patient controlled analgesia (PCA) on the prevention of chronic pain of patients undergoing VATS.
Detailed description
Video-assisted thoracoscopic surgeries (VATS) include significant postoperative acute and chronic pain because of trocar site tissue damages, intercostal nerve injuries and related inflammatory responses. Poorly controlled pain in the early postoperative period usually causes chronic pain, and also affects patients' physiotherapy, mobilization and daily function. Our hypothesis in this study is 'thoracic paravertebral block (TPVB) is associated with an improvement in control of acute and chronic pain after VATS compared to systemic analgesia.
Interventions
Thoracic paravertebral block (TPVB) is being performed by injecting 5 mL of Bupivacaine 0.5% to 4 consecutive level of paravertebral spaces between T4 and T8 by using landmark technique
IV morphine patient controlled analgesia (PCA) is being used in the postoperative period for 48 hours. Basal infusion: 0.3 mg/kg/h, Bolus: 1 mg, Lock-out time: 20 min, 4-h limit: 10-12,5 mg
Sponsors
Istanbul University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
TRIPLE (Subject, Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to 65 Years
Healthy volunteers
No
Inclusion criteria
ASA I-III Patients who undergo Video-assisted thoracoscopic surgery (VATS) under GA
Exclusion criteria
Patients with difficult understanding the instructions for using PCA and/or pain scales Patients with contraindication to regional anesthesia Patients with significant neurologic, psychiatric or cognitive disorders History of substance abuse or chronic opioid use
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Postoperative chronic pain scores (VAS) at rest and during mobilization | Up to 6 months | Chronic pain follow-up |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Postoperative acute pain at rest and during coughing/mobilization | 0-48 hours | Postoperative acute pain score (VAS) follow-up |
| Postoperative nausea and vomiting (PONV) and antiemetic requirements | 0-48 hours | Postoperative acute PONV and antiemetic use follow-up |
| Postoperative morphine consumption | 0-48 hours | Postoperative IV PCA morphine consumption for Group 1 and IV morphine consumption for Group 2 as rescue analgesic |
| Postoperative vital signs | 0-48 hours | Postoperative early period hemodynamic follow-up |
| Postoperative first oral intake, flatulence, defecation, mobilization times | 0-48 hours | Postoperative first oral intake, flatulence, defecation, mobilization times |
| Postoperative hospital discharge day and time | Participants is being followed for the duration of hospital stay, an expected average of 1 week | Postoperative hospital discharge day and time |
| Postoperative long term (1st, 3rd and 6th months) analgesic, sleep quality and comfort follow-up | Up to 6 months | Postoperative long term (1st, 3rd and 6th months) analgesic, sleep quality and comfort follow-up with phone call |
| Time to first analgesic | 0-48 hours | Postoperative first analgesic IV PCA morphine demand time for Group 1 and first rescue analgesic IV morphine time for Group 2 |
Countries
Turkey (Türkiye)
Outcome results
None listed