Ultrasound Guided Erectror Spinae Block Versus Intracavitary During Medical Thoracoscopy (ESPB)
Ultrasound-Guided Erector Spinae Plane Block Versus Intracavitary Local Anaesthesia for Peri-procedural Analgesia During Medical Thoracoscopy: A Randomized Control Trial
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment (Estimated)
Enrollment
Phase
Phase
- Phase 2
- Phase 3
Contacts and Locations
Study Contact
Study Contact
- Name: Donia Hany Hany, MD
- Phone Number: 01014498540
- Email: doniahany1788@gmail.com
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
- Adult
- Older Adult
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- 100 patients belonging to American Society of Anesthesiologists (ASA) I-III scheduled for medical thoracoscopy under adequate sedation and analgesia.
Exclusion Criteria:
- Patients will be excluded if; history of allergy or contraindication to any of the studied drugs, BMI more than 35 kg/m2 chronic opioid use or abuse, patients for whom ESPB block is contraindicated (patient refusal, coagulation disorder, skin infection at the injection site), history of post-thoracotomy, chest wall deformity, severe uncontrolled comorbidity, intubated patients, or if the interventional physician wants general anaesthesia from the start
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Triple
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
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Active Comparator: 50 patients will receive two levels of ultrasound-guided erector spinae plane block (ESPB) at T5 an
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On the lateral decubitus position, under full aseptic technique; a high frequency (5-13 MHz) linear probe (or curvilinear in obese patients) of ultrasound covered sterilely will be placed in a parasagittal longitudinal orientation approximately 3 cm lateral to the spinous process to identify the trapezius, rhomboid major (if present), erector spinae muscle and thehyperechoic transverse process with its acoustic shadow, with the target being the fascial plane deep to the erector spinae muscle and superficial to the transverse process; the needle will be inserted in-plane in a cranial-to-caudal direction under real-time ultrasound guidance until it contacts the transverse process, after which 1-3 ml of normal saline is injected to confirm correct plane by lifting the erector spinae muscle off the transverse process, then following negative aspiration 20 ml of 0.25% bupivacaine at each level (10 ml 0.5% bupivacaine + 10 ml normal saline ) will be injected incrementally
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Active Comparator: patients will receive intracavitary anaesthesia ICA with total volume 40 ml, 20 ml of 0.25% bu
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After skin infiltration with lidocaine 2%, at the entry point of the trocar, small (2-4 cm) skin incision in the chest wall will be done, A trocar will be introduced into the pleural cavity.
If necessary, air is introduced to allow the lung to collapse, creating space to view the pleural surface.
The thoracoscope will be inserted to visualize the pleura.
The interventional pulmonologist will receive the pre-prepared syringe from the block anaesthetist and will administer the solution intracavitarily via the thoracoscope working channel, without knowledge of its contents.
In both groups, a total volume of 40 mL of solution is administered: 20 mL is sprayed over the costal, diaphragmatic, and mediastinal pleura via the thoracoscope working channel, and an additional 20 mL is injected through the chest tube inserted at the end of the procedure , 10-mL normal saline flush, and the chest tube is then clamped for 5 minutes
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What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Time Frame |
|---|---|
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The primary aim: is to compare the effect of US guided ESP block at two levels versus intracavitary blockade in medical thoracoscopy on total peri procedural nalbuphine (mg) consumption during medical thoracoscopy
Time Frame: intraoperative and post-operative 12 hours
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intraoperative and post-operative 12 hours
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Collaborators and Investigators
Sponsor
Sponsor
Study record dates
Study Major Dates
Study Start (Estimated)
Study Start
Primary Completion (Estimated)
Primary Completion
Study Completion (Estimated)
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 (Actual)
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
- Medical pleuroscopy
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
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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