Serratus Anterior Plane Block Combined With Transversus Thoracic Muscle Plane Block Versus Conventional Local Anesthetic Infiltration for SICD Implantation: A Randomized Controlled Trial
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Locations
-
-
New York
-
Brooklyn, New York, United States, 11215
- New York Methodist Hospital
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Patient is able to provide a written informed consent.
- Patient is scheduled to have an elective SICD implantation procedure.
- Patient has none of the exclusion criteria
Exclusion Criteria:
- Patient is unable to provide a written informed consent.
- Patient is younger than 18 years old.
- Patients with prior thoracotomy or other thoracic surgery altering anatomy.
- Patients with neurological deficits.
- Patients with impaired coagulation (Platelet count < 50,000 cells/mcl and/or INR > 1.4).
- Patient on anticoagulation therapy.
- Patient's weight below 50 kg
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Double
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: Combined serratus anterior plane block and transversus thoracis plane block
The study group will receive a combined plane block by a dedicated anesthesia team prior to their procedure.
20 mL of local anesthetic (0.25% bupivacaine) will be injected for the Serratus anterior plane block and another 20 mL of local anesthetic (0.25% bupivacaine) will be injected in transversus thoracis plane block
|
The study group will receive a combined plane block by a dedicated anesthesia team prior to their procedure.
20 mL of local anesthetic (0.25% bupivacaine) will be injected for the Serratus anterior plane block and another 20 mL of local anesthetic (0.25% bupivacaine) will be injected in transversus thoracis plane block
|
|
Active Comparator: Stand local anesthetic infiltration
Local anesthetic infiltration of the incision sites will be performed by the cardiologist prior to, and as, necessary during the procedure.
The amount of local anesthetic used will be determined intraoperatively by the cardiologist according to the patients' requirements.
|
Local anesthetic infiltration of the incision sites will be performed by the cardiologist prior to, and as, necessary during the procedure.
The amount of local anesthetic used will be determined intraoperatively by the cardiologist according to the patients' requirements.
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Postoperative pain score measured
Time Frame: 1 day
|
by Numerical Rating Scale pain (0-10), 0 is no pain, 10 is the worst
|
1 day
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Intraoperative pain score measured
Time Frame: Intraoperative
|
by Numerical Rating Scale pain
|
Intraoperative
|
|
Intraoperative sedation score
Time Frame: Intraoperative
|
Richmond Agitation Sedation Scale (RASS) (+4 to -5) +4 combative -5 unarousable |
Intraoperative
|
|
Total local anesthetic volume used
Time Frame: Intraoperative
|
Total local anesthetic volume used
|
Intraoperative
|
|
Procedure duration
Time Frame: Intraoperative
|
Procedure duration
|
Intraoperative
|
|
Intraoperative hemodynamics
Time Frame: Intraoperative
|
Intraoperative hemodynamics
|
Intraoperative
|
|
Time to 1st rescue pain medication
Time Frame: 1 day
|
Time to 1st rescue pain medication after surgery
|
1 day
|
|
Postoperative opioid consumption
Time Frame: 1 day
|
Amount of opioids consumed after surgery
|
1 day
|
|
Patient satisfaction
Time Frame: 1 day
|
How much is the patient satisfied with the pain management in the perioperative period
|
1 day
|
|
Block related complications
Time Frame: 1 day
|
Any complications that may happen from either blocks, e.g infection, bleeding
|
1 day
|
Collaborators and Investigators
Sponsor
Sponsor
Publications and helpful links
General Publications
- Burke MC, Gold MR, Knight BP, Barr CS, Theuns DAMJ, Boersma LVA, Knops RE, Weiss R, Leon AR, Herre JM, Husby M, Stein KM, Lambiase PD. Safety and Efficacy of the Totally Subcutaneous Implantable Defibrillator: 2-Year Results From a Pooled Analysis of the IDE Study and EFFORTLESS Registry. J Am Coll Cardiol. 2015 Apr 28;65(16):1605-1615. doi: 10.1016/j.jacc.2015.02.047.
- Weiss R, Knight BP, Gold MR, Leon AR, Herre JM, Hood M, Rashtian M, Kremers M, Crozier I, Lee KL, Smith W, Burke MC. Safety and efficacy of a totally subcutaneous implantable-cardioverter defibrillator. Circulation. 2013 Aug 27;128(9):944-53. doi: 10.1161/CIRCULATIONAHA.113.003042.
- Essandoh MK, Otey AJ, Abdel-Rasoul M, Stein EJ, Turner KR, Joseph NC, Daoud EG. Monitored Anesthesia Care for Subcutaneous Cardioverter-Defibrillator Implantation: A Single-Center Experience. J Cardiothorac Vasc Anesth. 2016 Oct;30(5):1228-33. doi: 10.1053/j.jvca.2016.06.007. Epub 2016 Jun 8.
- Afzal MR, Okabe T, Koppert T, Tyler J, Houmsse M, Augostini RS, Hummel JD, Kalbfleisch SJ, Iyer MH, Flores AS, Bhandary S, Dimitrova G, Elsayed-Awad H, Fiorini K, Gorelik L, Perez W, Saklayen S, Stein E, Turner K, Franklin NP, Ryu JN, Bhatt A, Weiss R, Daoud EG, Essandoh M. Implantation of subcutaneous defibrillator is feasible and safe with monitored anesthesia care. Pacing Clin Electrophysiol. 2019 Dec;42(12):1552-1557. doi: 10.1111/pace.13838. Epub 2019 Nov 18.
- Ziacchi M, Bisignani G, Palmisano P, Scalone A, Martignani C, Elvira Mocavero P, Caravati F, Della Cioppa N, Mazzuero A, Pecora D, Vicentini A, Landolina ME, Debonis S, Scimia P, Lovecchio M, Valsecchi S, Diemberger I, Droghetti A. Serratus anterior plane block in subcutaneous implantable cardioverter defibrillator implantation: A case-control analysis. J Cardiovasc Electrophysiol. 2020 Jan;31(1):144-149. doi: 10.1111/jce.14293. Epub 2019 Dec 3.
- Miller MA, Garg J, Salter B, Brouwer TF, Mittnacht AJ, Montgomery ML, Honikman R, Arkonac DE, Choudry S, Dukkipati SR, Reddy VY, Weiner MM. Feasibility of subcutaneous implantable cardioverter-defibrillator implantation with opioid sparing truncal plane blocks and deep sedation. J Cardiovasc Electrophysiol. 2019 Jan;30(1):141-148. doi: 10.1111/jce.13750. Epub 2018 Oct 22.
- Uran C, Giojelli A, Borgogna DA, Morello G, Marullo F, Iodice P, Greco A, Accogli M, Guido A, Palmisano P. Ultrasound-guided serratus anterior plane block combined with parasternal block in subcutaneous implantable cardioverter defibrillator implantation: Results of a pilot study. Pacing Clin Electrophysiol. 2020 Jul;43(7):705-712. doi: 10.1111/pace.13944. Epub 2020 Jun 3.
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Estimated)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Other Study ID Numbers
Other Study ID Numbers
- 1723038-1
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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