Epidural Block, Oesophageal Cancer, Oesophagectomy
Conditions
Keywords
hemodynamic effect, para vertebral block
Brief summary
Continuous Paravertebral block (PVB) was reported to provide less episodes of hypotension than continuous thoracic epidural block (TEB). The maintenance of optimal tissue perfusion is essential for esophageal anastomosis in patients undergoing oesophagectomy. the aim of this study is to compare Hemodynamic effect of continous PVB compared to TEB , in patient undergoing oesophagectomy with laparoscopy and thoracotomy.
Interventions
OTHERparavertebral block
in the paravertebral block , the catheter was placed under ultrasound echography , at the right thoracic T4/T5 level
in the epidural block the catheter was inserted without echography , at T4/T5 level
DRUGropivacaine
DRUGSufentanil
Sponsors
University Hospital, Lille
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
SUPPORTIVE_CARE
Masking
SINGLE (Subject)
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
* ASA score 1 to 3 * oesophagectomy : abdominal time with laparoscopy ans thoracic time with thoracotomy
Exclusion criteria
* pregnancy * Uncooperative patient * patient refusal * Coagulopathy * allergy to local anesthetic * Psychological Disorders * Failure to install the epidural or paravertebral catheter. The patient will therefore be excluded secondarily but will be able to benefit from an alternative technique for the management of his pain. * Sepsis * Skin infection at the puncture site * Allergy to local anesthetics * Esophagectomy with cervical surgical time * Patient with chronic pain EVA\> 4 before surgery.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Frequency of hypotension episodes | during perioperative until first 24 hours post operative | The frequency of hypotension episodes defined by a mean arterial pressure (MAP) less than 70mmHg or a decrease in MAP greater than 20% when compared with the preoperative value |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Frequency of use of vasopressor agents | during perioperative until first 24 hours post operative | — |
| Volumes of fluid administered | during perioperative until the first 24h hours post operative | — |
| total amount of morphine consumption | during first 48 hours post operative | — |
| visual analog scale | during first 48 hours post operative, at 3 months and 6 months | Measure the pain severity |
| Total amount per patient and per group of vasopressins amines | during perioperative until first 24 hours post operative | — |
| Frequency of surgical complications | during first 48 hours post operative | — |
| Frequency of pulmonary complications | during first 48 hours post operative | — |
| total amount and frequency of Post-operative anti-emetic consumption | during first 48 hours post operative | — |
| Death | up to 28 days postoperative | — |
| DN2 score | during first 48 hours post operative, at 3 months and 6 months | evaluation with validated scores for chronic and neuropathic pains |
Countries
France
Outcome results
None listed