Postoperative Pain, Thoracic Cancer
Conditions
Keywords
serratus anterior plane block, ultrasound-guided, regional anesthesia, thoracic surgery, postoperative pain
Brief summary
The investigators aimed to assess Ultrasounde- guided serratus anterior plane block can be effective in acute postoperative pain following thoracic surgery.
Detailed description
Analgesic options for thoracotomy are various with each having their own merits and demerits.Thoracic epidural is said to be the gold standard for management of thoracotomy pain. However, it is invasive procedure and many side effects. Other options include paravertebral block, interpleural block, intrathecal opioids. Especially, paravertebral block is thought good alternative to epidural anethesia. Most of these invasive neuraxial techniques demand normal coagulation parameters to be present. The serratus anterior plane block(SAPB) was done under ultrasound guidance in the mid-axillary line at the level of the fourth rib and the catheter was placed superficial to the serratus plane. The patient expressed relief in pain within 10 minutes of being given the bolus of local anaesthetic.Pain following thoracotomy is chiefly due to rib retraction, and damage to the serratus/intercostal muscles and intercostal nerves. A SAPB addresses both these aspects. SAPB has been mentioned in previous studies for management of rib fractures and breast surgeries. The investigators try to evaluate whether the SAPB is easy to perform and provides effective analgesia in patients undergoing thoracotomy with minimal side effects.
Interventions
PROCEDUREserratus anterior plane block
before surgery :ultrasound-guided serratus anterior plane block
DRUGpatient controlled analgesia
two groups have same intravenous patient controlled analgesia
Sponsors
Samsung Medical Center
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
DOUBLE (Caregiver, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
20 Years to 80 Years
Healthy volunteers
No
Inclusion criteria
•undergoing thoracic surgery (lobectomy or segmentectomy)
Exclusion criteria
• allergy to any drugs chronic pain disease with medication psychologic disorder anti-depressant drug chronic kidney disease ( Cr over 2.0 mg/dl) coagulopathy
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| opioid consumption | the first 24hour in postoperative phase | the dose of PCA and residual opioid |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| postoperative pain scale | intraoperative(immediately after surgery), postoperative 6 ,12, 24 hour | numeric rating scale |
| opioid consumption | the first 6,12 hour in postoperative phase | the dose of PCA and residual opioid |
Other
| Measure | Time frame | Description |
|---|---|---|
| questionnaire about patient's satisfaction for pain management | postoperative 24 hour | score 1(bad)-5(good) |
Countries
South Korea
Outcome results
None listed