Nerve Block, Thoracoscopic Surgery
Conditions
Brief summary
After thoracoscopic surgery, patients still face moderate to severe pain. How to effectively control pain and promote postoperative recovery of patients is a challenging problem. Thoracic paraspinal block is effective in controlling pain after thoracoscopic surgery, but it also carries the risk of difficulty in operation and puncture of the pleura. In recent years, erector spinal plane block and serratus anterior plane block have been used for postoperative analgesia after thoracoscopic surgery. The purpose of this study was to explore whether erector spinal plane combined with serratus anterior plane block can replace thoracic paravertebral block and provide a more complete analgesia after thoracoscopic surgery. Therefore, this study is of great clinical significance.
Detailed description
In a double-blind randomized controlled study, investigators allocated 92 patients undergoing VATS to either SAPB Combined With ESPB or TPB, with both groups receiving otherwise standardized treatment, including multimodal analgesia. The primary outcome was 24-hr opioid consumption. Secondary outcomes included the number of survival analgesia at 1, 2, 4, 8, and 24 hours postoperatively ,VAS scores was assessed during resting and coughing statuses at 1, 2, 4, 8, and 24 hours postoperatively, pulmonary function indexes before and 1, 4, 24 hours after surgery , QOR-15 scores before and 24 hours after surgery, postoperative complications and recovery time nodes drainage tube removal time, discharge time.
Interventions
PROCEDUREerector spinal plane combined with serratus anterior plane block
The experimental group received ultrasound-guided erector spinal block combined with serratus anterior plane block, and erector spinal block was performed at the T5 and T7 levels with 10ml 0.4% ropivacaine for each level, and 20ml 0.4% ropivacaine for serratus anterior plane block. The control group received ultrasound-guided thoracic paravertebral block at T5 and T7 levels, respectively, with 20ml 0.4% ropivacaine at each level.
Sponsors
Zhangyi
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
OTHER
Masking
QUADRUPLE (Subject, Caregiver, Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to 70 Years
Healthy volunteers
No
Inclusion criteria
1. American ASA Grade I-III; 2. Age: 18 \ 70 years old; 3 BMI 19 \ 28kg/m2; 4\. Patients with elective thoracoscopic partial pneumonectomy under general anesthesia; 5 Informed Consent has been signed.
Exclusion criteria
1. Use opioid analgesics on a daily basis or have a history of opioid abuse; 2. History of ipsilateral thoracotomy; 3. Allergic to any of the drugs used in the study, or have a history of drug allergy; 4. Mental or nervous system diseases, motor or sensory deficits; 5 there is coagulation dysfunction; 6\. Cognitive dysfunction, unable to cooperate with research; 7\. Severe renal, hepatic or cardiac dysfunction; 8\. Chest wall and spine trauma, infection, deformity and other cases where nerve block cannot be performed; 9\. Participated in other clinical trials within the 3 months prior to study inclusion; 10\. Investigators consider other reasons unsuitable for clinical trial participants; 11\. Patients refuse to participate.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| The dose of opioids used | 24 hours after surgery | dosage of analgesic pump |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| The number of survival analgesia | 1hour, 2hours, 4hours, 8hours, 24hours and 48hours after surgery | times of rescue analgesia |
| VAS scores at resting and coughing state | 1hour, 2hours, 4hours, 8hours, 24hours and 48hours after surgery | visual analog pain scale |
| The dose of opioids used | 1hour, 2hours, 4hours, 8hours and 48hours postoperatively after surgery | dosage of analgesic pump |
| QOR-15 scores | before and 24 hours after surgery | The highest score is 150,the lowest score is 0. The higher the score, the better off the patient was. |
| Postoperative complications and recovery time nodes | follow up patients for an average of half a month | drainage tube removal time, length of stay, etc. |
| pulmonary function indexes | Preoperative, postoperative 1hour, postoperative 4hours and postoperative 24hours | FVC (L) |
Countries
China
Contacts
Primary ContactYi Zhang, Dr.
Backup ContactXuan Mo
Outcome results
None listed