Lung Cancer, Postoperative Pain
Conditions
Keywords
Epidural analgesia, Pneumonectomy
Brief summary
Thoracic epidural analgesia (TEA) is the basic method of analgesia in patients undergoing pulmonary lobectomy. TEA is considered to be a safe and thoroughly investigated method of pain relief that rarely causes serious complications. However, blocking the nerves as they emerge from the spinal column (paravertebral block, PVB) may represent an alternative method with some potential benefits. In this study, TEA and PVB will be compared for patients undergoing pulmonary lobectomy by video assisted thoracoscopic surgery. The aim of the study is to test the hypothesis, that PVB is a time-saving procedure compared with TEA on the day of surgery and that PVB is as efficient in postoperative pain reduction as TEA.
Interventions
Standard thoracic epidural (needle inserted into the space between the covering of spinal cord and the cord itself) preoperatively. Standard thoracic epidural analgesia mixture (2 mg/ ml bupivacaine, 2 µg/ ml fentanyl and 2 µg/ ml adrenalin) with an infusion of 6-10 ml/hour until day 2 postoperatively. Thereafter reduction by 30 % every four hours.
DRUGParavertebral block
Paravertebral block containing 5 ml bupivacaine 5 mg/ ml (optionally 10 ml bupivacaine 2,5 mg/ ml). In addition per-oral painkillers (oxycodone and paracetamol) from the day of surgery.
Sponsors
St. Olavs Hospital
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to 85 Years
Healthy volunteers
No
Inclusion criteria
Patients with lung cancer in stage 1 or 2 who are accepted for VATS-lobectomy
Exclusion criteria
, preoperative: Patients who do not wish to participate Patients with: * suspicion of ingrowth in the thoracic wall. * marginal lung function. * kidney failure. * chronic pains and/ or daily use of opioids. * cognitive, visual and / or linguistic dysfunction. * allergies to drugs used in the paravertebral block or the thoracic epidural analgesia.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Time in minutes total time at the operating ward | 1 hour | — |
| Pain intensity during hospitalization: Numerical Rating Scale (NRS) | Up to 12 months after surgery | using the Numerical Rating Scale (NRS) in predetermined time intervals after the operation |
Secondary
| Measure | Time frame |
|---|---|
| Hospital length of stay in days | until discharge from hospital (max 1 month) |
Countries
Norway
Outcome results
None listed