Pain Mangement of Thoracotomy
Conditions
Brief summary
A thoracotomy requires a very painful incision, involving multiple muscle layers, rib resection and continuous motion as the patient breathes. Treatment of acute post thoracotomy pain is particularly important not only to keep the patient comfortable but also to minimize pulmonary complications Though epidural analgesia was once considered as the gold standard for post-thoracotomy pain management, it is not recommended for pain control after thoracotomy surgery because it is associated with high potential risks of dural puncture, nerve lesions, epidural hematoma and hypotension(4). Thoracic paravertebral block (TPVB) and intercostal nerve block are well described and recognized techniques for postoperative analgesia following thoracic surgeries, such as thoracotomy and mastectomy
Interventions
Group CTB (n=30): patients included in this group will receive unilateral US-guided CTB after general anesthesia. The CTB will be performed by using 20 ml bupivacaine 0.25% Group ESPB (n=30): patients included in this group will receive unilateral US-guided ESPB after general anesthesia. The ESB will be performed by using 20 ml bupivacaine 0.25%
Sponsors
Sohag University
Study design
Allocation
NA
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to 75 Years
Healthy volunteers
No
Inclusion criteria
* • Age from 18 to 75 years old. * Both sexes. * American Society of Anesthesiologists (ASA) physical status I-II-III. * Patient undergoing unilateral thoracotomy surgery.
Exclusion criteria
* • BMI more than 30 kg/m2. * Patients who are taking analgesics for chronic illness or have a history of substance abuse. * Patients who are unable to describe their postoperative pain (e.g., language barrier or neuropsychiatric disorder). * Patients with a history of coagulopathy. * Severe heart diseases. * Hepatic or renal insufficiency. * Infection at the site of infiltration
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| study aims to compare the analgesic efficacy of CTB and ESPB for post-operative analgesia in patients undergoing thoracotomy. | 5months | study aims to compare the analgesic efficacy of CTB and ESPB for post-operative analgesia in patients undergoing thoracotomyA standardized analgesic regimen will be prescribed in the post-operative period. All patients will receive paracetamol 1 gm every 6 h as routine analgesia. If visual analogue scale (VAS) is more than 3, intravenous morphine 3mg will be administered as rescue analgesia If visual analogue scale (VAS) is more than 5 |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| The secondary outcome is the total postoperative morphine consumption, time of first analgesic, | 5months | The secondary outcome is the total postoperative morphine consumption, time of first analgesic A standardized analgesic regimen will be prescribed in the post-operative period. All patients will receive paracetamol 1 gm every 6 h as routine analgesia. If visual analogue scale (VAS) is more than 3, intravenous morphine 3mg will be administered as rescue analgesia If visual analogue scale (VAS) is more than 5 |
Contacts
Primary Contactahmed M mokhar, Resident
Backup Contactwesam A Abo Elwafa Sallam, Assistant professor
Outcome results
None listed