Acute Pain
Conditions
Brief summary
Video assisted thoracoscopic surgery (VATS) is a minimally invasive surgery to remove lesions from the thoracic cavity. It is associated with moderate pain which can lead to pulmonary complications after surgery. The Enhanced Recovery After Surgery (ERAS) and the European Society of Thoracic Surgeons recommended a multimodal analgesia approach to manage pain after VATS. Erector spinae block (ESB) is a popular analgesic block due to its ease of performance and wide coverage. It has been shown to be effective in randomized control trials. Recently, case reports on bi-level ESB are emerging, suggesting more effective analgesia compared to single level ESB. As there is no available data, the investigators are interested in conducting a randomized pilot study, comparing bi-level to single level ESB to gather baseline data for sample size calculation for a formal randomized trial.
Interventions
PROCEDUREBi-level erector spinae block
erector spinae block at 4th and 6th transverse process
PROCEDURESingle level erector spinae block
erector spinae block at 4th transverse process
Sponsors
London Health Sciences Centre Research Institute OR Lawson Research Institute of St. Joseph's
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Subject)
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* adult patients (at least 18 years old) * elective unilateral wedge resection, segmentectomy, lobectomy or bilobectomy via VATS
Exclusion criteria
* history of malignant hyperthermia * BMI \> 40, chronic pain condition * Daily opioid consumption of more than 60 mg oral morphine equivalents * Conversion to thoracotomy * Insertion of epidural * postoperative admission to ICU
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Opioid use in first 12 postoperaive hour | First 12 hour from arriving at postoperative recovery |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Pain score area under curve first 12 hour | First 12 hour from arriving at postoperative recovery | Numeric rating scale, 0 to 10, 0 being no pain and 10 being the worst possible pain |
| Pain score area under curve first 24 hour | First 24 hour from arriving at postoperative recovery | Numeric rating scale, 0 to 10, 0 being no pain and 10 being the worst possible pain |
| Incidence of Acute block complication - based on clinical assessment | First 12 hour since block placement | pneumothorax, local anesthetic toxicity, epidural spread, bleeding |
| Incidence of Delayed block complication - based on clinical assessment | First 5 days | paresthesia, motor weakness, hematoma, abscess |
Countries
Canada
Contacts
Primary ContactCheng Lin
Outcome results
None listed