External Oblique Intercostal Plane Block, Post Thoracotomy Pain, Thoracic Paravertebral Block
Conditions
Brief summary
The aim of this study is to compare the effectiveness of analgesia achieved by external oblique intercostal plane block (EOIPB)and thoracic paravertebral block (TPVB) for postoperative pain management in patients undergoing open thoracotomy.
Detailed description
Acute thoracotomy pain is multifactorial in nature. It involves nociceptive and neuropathic mechanisms originating from somatic and visceral afferents. The main sources of pain are intercostal nerves, the vagus nerve and phrenic nerve in the pleura, the superficial cervical plexus, and the brachial plexus in the ipsilateral shoulder.
Interventions
OTHERExternal oblique intercostal plane block
Patients will receive external oblique intercostal plane block
OTHERThoracic paravertebral block
Patients will receive thoracic paravertebral block
Sponsors
Tanta University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
DOUBLE (Subject, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Age ≥ 18 years. * Both sexes. * American Society of Anesthesiology (ASA) physical status I-III. * Scheduled for open thoracotomy
Exclusion criteria
* Patients with neurological or intellectual disability. * Infection at the injection site. * Opioid addiction. * Allergic reaction to local anesthetics. * Coagulation abnormalities. * Drug abuse. * Pregnancy. * Severe liver and/or renal failure. * Uncontrolled hypertension. * Severe cardiovascular problems. * Diabetes mellitus.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Total morphine consumption | 24 hours postoperatively | Rescue analgesia of morphine will be given as 2 mg bolus if the numeric rating scale (NRS) \> 3 to be repeated after 30 min if pain persists until the numeric rating scale \< 4. numeric rating scale will be assessed at 0, 4, 8, 12, 18 and 24h postoperatively. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Mean arterial pressure | Till the end of surgery | Mean arterial pressure will be recorded preoperative, before performing of block, and every 15 min till the end of surgery. |
| Heart rate | Till the end of surgery | Heart rate will be recorded preoperative, before performing of block, and every 15 min till the end of surgery. |
| Intraoperative fentanyl consumption | Intraoperative | Additional fentanyl bolus dosages of 1 µg/kg IV will be administered if heart rate or mean arterial blood pressure elevated more than 20% of the baseline (after exclusion of other causes than pain). |
| Degree of pain | 24 hours postoperatively | Degree of pain will be measured using numeric rating scale (NRS) (0 represents no pain while 10 represents the worst pain imaginable).NRS will be assessed at 0, 4, 8, 12, 18 and 24h postoperatively. |
| Complications | 24 hour postoperatively | Complications such as bradycardia, hypotension, nausea, vomiting, respiratory depression, local anesthetic systemic toxicity (LAST) or any other complication will be recorded. |
| Time to the 1st rescue analgesia | 24 hours postoperatively | All patients will receive paracetamol 1 gm every 6 h as routine analgesia. Rescue analgesia of morphine will be given as 2 mg bolus if the numeric rating scale \> 3 to be repeated after 30 min if pain persists until the numeric rating scale \< 4. NRS will be assessed at 0, 4, 8, 12, 18 and 24h postoperatively |
Countries
Egypt
Outcome results
None listed