Erector Spinae Plane Block, Multimodal Analgesia, Pain, Postoperative, Serratus Anterior Plane Block, Thoracic Surgery, Video-Assisted
Conditions
Brief summary
Video-assisted thoracic surgery (VATS) has become a common procedure in thoracic surgery. Severe postoperative pain may be encountered in patients undergoing VATS. Analgesic methods such as thoracic paravertebral block (TPVB), intercostal block and erector spina plane block (ESPB) are widely used for VATS. Among these methods, ultrasound (US) guided TPVB is the most preferred method. In recent years, the frequency of application of plane blocks as a component of multimodal analgesia has been increased. ESPB and SAPB are some of them. Generally, comparisons are made between ESPB and TPVB in studies and the analgesic effect is evaluated.There are two techniques for SAPB application. In Deep SAPB (DSAPB) application, local anesthetic agent is given under the serratus anterior muscle. In the Superficial SAPB (SSAPB) application, the local anesthetic agent is given above the serratus anterior muscle. Since it is done by entering from the same point in two applications, it is possible to perform these two applications at the same time with a single needle entry. The mechanisms of regional analgesia techniques used after thoracic surgery operations are also different from each other. Therefore, it may be possible to obtain a more effective analgesic effect in patients by combining the mechanism of action of DSAPB and SSAPB , as in the multimodal analgesia method. This study seeks to evaluate the effect of ESPB and combined DSAPB-SSAPB pain after VATS.
Interventions
PROCEDUREErector Spinae Plane Block
Erector Spinae Plane Block will be performed unilaterally, under US guidance, before the surgical operation, after the induction of anesthesia, when the patient is placed in the lateral decubitus position. 20 ml of 0.25% bupivacaine will be used in applications.
PROCEDUREDeep and Superficial Serratus Anterior Plane Block
Combined Deep and Superficial Serratus Anterior Plane Block will be performed unilaterally, under US guidance, before the surgical operation, after the induction of anesthesia, when the patient is placed in the lateral decubitus position. 20 ml of 0.25% bupivacaine will be used in applications.
Sponsors
Atatürk Chest Diseases and Chest Surgery Training and Research Hospital
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
DOUBLE (Subject, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to 65 Years
Healthy volunteers
No
Inclusion criteria
* Age between 18 and 65 years * American Society of Anesthesiologists physical status I-II-III * Body mass index between 18-30 kg/m2 * Patients undergoing elective video assiste thoracoscopic surgery
Exclusion criteria
* Patient refusing the procedure * History of chronic analgesic or opioid therapy * History of local anesthetic allergy * Infection in the intervention area * Emergency surgery
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Pain scores | 1st, 2nd, 4th, 8th, 16th, 24th and 48th hours after surgery | Pain will be assessed at rest and while coughing using the visual analog scale on a scale from 0 (no pain) to 10 (worst pain). Pain assessment will be done at 1st, 2nd, 4th, 8th, 16th, 24th and 48th hours after surgery. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Morphine Consumption | 24 hours after surgery | Postoperative intravenous morphine infusion therapy will be administered with patient-controlled analgesia (PCA) method. Thanks to PCA, how much morphine the patient needs will be followed in mg. |
Countries
Turkey (Türkiye)
Outcome results
None listed