Erector Spinea Plane Block
Conditions
Brief summary
After the completion of erector spinae plane block, the patient maintains different positions to assess the diffusion of local anesthetic and the effect of the block.
Detailed description
Eighty-four patients were selected to undergo CT guided puncture localization of pulmonary nodules under local anesthesia, and the patients were divided into groups using a computer-generated random number in a ratio of 1:1:1. To ensure objectivity, a nurse who was not involved in the study prepared a sealed opaque envelope containing grouping information. Randomly divide patients into three groups: supine position group (S group, 28 patients), prone position group (P group, 28 patients), and lateral position group (L group, 28 patients). The patients underwent ultrasound guided ESPB on the puncture side before CT puncture localization. Ultrasound guided ESPB method: Using an ultrasound high-frequency linear array probe (5-13MHz, Sonosite, USA), the probe is placed parallel to the spine on the surface of the transverse process tip of the seventh thoracic vertebrae. Under ultrasound, the transverse process and spinal muscles are clearly exposed. Then, a short inclined plane puncture needle is used, and the needle is inserted from the head side using in-plane technology. After the needle tip reaches between the transverse process and erector spinae muscles, 1ml of physiological saline is injected using water separation technology to confirm the position of the needle tip, Then inject 30ml of local anesthetic solution (0.75% ropivacaine 15ml+iohexol 15ml). After the block was completed, patients in Group S remained in a supine position; Patients in group L maintained the blocking side above; Patients in Group P maintained a prone position. After 30 minutes of block completion, CT scan and puncture localization were performed, following with 3D reconstruction. The primary outcome was LA-contrast spread to the paravertebral space.The second outcomes were as follow: 1. spread to the neural foramina 2. cranio-caudal spread 3. spread to the epidural space 4. spread to the intercostal space.
Interventions
OTHERAlteration of patients' position after erector spinae plane block
After the erector spinae plane block was completed, the patients kept supine, lateral or prone position according to the group allocated for 30 minute to ensure the spread of local anesthetic
Sponsors
Nanjing First Hospital, Nanjing Medical University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
DOUBLE (Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to 80 Years
Healthy volunteers
Yes
Inclusion criteria
Patients received CT guided puncture localization of pulmonary nodules under local anesthesia
Exclusion criteria
1. Allergic to local anesthetic 2. History of opioid abuse 3. Severe skin infection 4. Peripheral neuropathy 5. Dysfunction of blood coagulation
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Incidence and number of local anesthetic diffusion segment into the paravertebral space | 30 minute after completion of the ESPB block | Observation of local anesthetic spread spread into the paravertebral space with CT by a researcher who was blinded to group allocation |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Diffusion of local anesthetic into the epidural space | 30 minute after completion of the block | Incidence and segment of local anesthetic spread into the epidural was assessed by a researcher who was blinded to group allocation |
| Diffusion of local anesthetic into intercostal space | 30 minute after completion of the block | The diffusion of local anesthetics to intercostal space was observed with CT by a researcher who was blinded to group allocation |
| Sensory loss of cold | 30 minute immediately after completion of the nerve block | The extent of sensory loss was assessed with cold stimulation, including the anterior chest wall (midclavicular line), lateral chest wall (posterior axillary line), and posterior chest wall (paraspinal zone) by a researcher who was blinded to group allocation |
Countries
China
Outcome results
None listed