Thoracic Anesthesia, Nerve Block, Pain, Acute
Conditions
Keywords
ultrasound-guided nerve block, postoperative pain
Brief summary
Ultrasound-guided mid-point transverse process to pleura block, erector spinae plane block and paravertebral block are three different methods of nerve block, used for relieving postoperative pain in thoracic anesthesia. This study is to compare them on block effects, postoperative pain and analgesic consumption in video-assisted thoracic surgery.
Detailed description
Ultrasound-guided nerve block is an important part of multi-mode analgesia to decrease the consumption of opioids. Thoracic paravertebral block is considered as an ideal regional analgesic choice for video-assisted thoracic surgery, but it still has some side effects, such as pneumothorax, vascular injury, especially for novices. Recent years, ultrasound-guided mid-point transverse process to pleura block and erector spinae plane block are reported for thoracic surgery. The insertion depth in these two methods is more superficial than traditional paravertebral block. They could have less side effects. Therefore, we design a randomised control study to compare them on block effects, postoperative pain and analgesic consumption in video-assisted thoracic surgery.
Interventions
PROCEDUREParavertebral block
Patients receive ultrasound-guided paravertebral block
PROCEDUREESP block
Patients receive ultrasound-guided erector spinae plane (ESP) block
PROCEDUREMTP block
Patients receive ultrasound-guided mid-point transverse process to pleura (MTP) block
Sponsors
Huazhong University of Science and Technology
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
TRIPLE (Subject, Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to 70 Years
Healthy volunteers
No
Inclusion criteria
* selective lobetomy under VATS * ASA classfication 1-3
Exclusion criteria
* history of thoracic surgery * double lateral VATS * allergy to local anesthetics * coagulation disorders * severe heart diseases, hepatic or renal insufficiency * a history of chronic pain or chronic opioid use * psychiatric disease or uncooperative * BMI\>28 kg/m2 * VATS transfered to open thoractomy
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| postoperative morphine consumption | postoperative 24 hours | The dose is according to the record from PCA pump |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Pain score at rest | at 0, 8, 24 hour after surgery | measured by VAS (0-10) |
| Pain score while coughing | at 0, 8, 24 hour after surgery | measured by VAS (0-10) |
Other
| Measure | Time frame | Description |
|---|---|---|
| block level | 20 minutes after block | measured by pin-prick at clavicle midline |
| intraoperative analgesic comsumption | intraoperative, from induction to emergence from anesthesia | the dose of sufentanil, remifentanil |
Countries
China
Contacts
Primary ContactWenlong Yao, MD
Outcome results
None listed