- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT01842698
Ultrasound-guided PVB (BPV échoguidé)
Feasibility of the Use of Ultrasound-guided Paravertebral Catheterisation for the Analgesic Management of Thoracotomy
Thoracotomy, is a surgical procedure performed routinely in connection with pulmonary surgery. Pain induced by thoracotomy is considered as the most severe post-operative pain. Control of the pain is essential in the perioperative management.
Nowadays, there are several strategies to support this pain, including regional anesthesia techniques in the context of multimodal analgesia. Epidural analgesia reduces pain scores and respiratory complications significantly. ParaVertebral Block (PVB) is a technique as effective as epidural analgesia in the treatment of pain after thoracotomy and could present a more limited number of complications. However, there is no consensus on the best technique for realisation of PVB.
Para-vertebral catheterisation can be performed by posterior approach in seeking a strength loss after bone contact of transverse vertebral process using the technique of Eason and Wyatt, but it is a blind technique. The ultrasonographic control, developed in the context of all puncture invasive actions, is an effective contribution to the realisation of a BPV, but still insufficiently validated. First used to measure the distance skin - posterior costo-transverse ligament and skin - parietal pleura before procedure, the ultrasonography has recently led to the publication of echo-guided techniques combining recognition of structures defining the space para- vertebral, viewing the progression of the needle and the spread of the local anesthetic. The handling of the ultrasonographic probe associated with the puncture requires additional learning.
The objective of this project is to study the feasibility of para-vertebral catheter insertion under ultrasonographic control. The appearance like "pigtail" of the catheter, the most recently proposed, seems the more attractive in terms of safety. The aim of this pilot prospective study is accurately quantify all qualitative parameters related to the technique in order to achieve a future validation with a medico-economic component.
Ultrasound-guided technique will correspond to a technique with a puncture of the lateral to medial space described by Shibata, after spotting of the first rib proposed by Bouzinac.
This study will be proposed to patients undergoing thoracotomy for total or partial pulmonary resection in Thoracic Surgery service of Centre Jean Perrin, the number of patients required is 60 patients over a period of inclusion of 12 months.
Study Overview
Status
Intervention / Treatment
Detailed Description
Prospective followed of cohort including consecutive patients, all receiving the same technique of anesthesia and analgesia:
- Preoperative para-vertebral catheterisation on the surgery side.
- Preoperative test of the efficiency of para-vertebral block.
- Conventional general anesthesia.
- Conventional rescue postoperative analgesia.
- Systematic radiographic control with injection of contrast product into the para-vertebral catheter.
- Conventional postoperative monitoring.
Study Type
Enrollment (Anticipated)
Phase
- Phase 2
Contacts and Locations
Study Locations
-
-
-
Clermont-Ferrand, France, 63000
- Centre de lautte contre le cancer - Centre Jean Perrin
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Patients undergoing programmed lateral or posterolateral thoracotomy, regardless of indication,
- Aged 18 to 80 years
Exclusion Criteria:
- Surgery performed in the emergency;
- Specific clinical contexts including neoplasia in terminal phase or palliative phase;
- Contraindications to the products of the study
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: N/A
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: ultrasoundguided paravertebral catheter
|
Other Names:
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
The overall failure rate of the para-vertebral block
Time Frame: 24 hours
|
The overall failure rate of the para-vertebral block ( failed installation or efficiency)
|
24 hours
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
The time (in minutes) between the start of the installation and the effective para-vertebral block obtaining
Time Frame: 24 hours
|
Effective para-vertebral block obtaining
|
24 hours
|
Paravertebral block catheterisation
Time Frame: 24 hours
|
•Paravertebral catheterisation efficiency
|
24 hours
|
Paravertebral block efficiency
Time Frame: 24 hours
|
Paravertebral block efficiency
|
24 hours
|
Pain evaluation
Time Frame: H0+30 min, +1h, +1h30, +2h, +4h, +8h, +12h, +16h, +20h, +24h, +32h, +40h, +48h
|
•Pain evaluation with Analogic Visual Scale
|
H0+30 min, +1h, +1h30, +2h, +4h, +8h, +12h, +16h, +20h, +24h, +32h, +40h, +48h
|
Tolerance hemodynamic, nausea and vomiting
Time Frame: 72 hours
|
Tolerance hemodynamic, nausea and vomiting reporting
|
72 hours
|
Collaborators and Investigators
Sponsor
Investigators
- Principal Investigator: Hammou TAHERI, PhD, Centre de lutte contre le cancer - Centre Jean PERRIN
Study record dates
Study Major Dates
Study Start
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Estimate)
Study Record Updates
Last Update Posted (Estimate)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- BPVéchoguidé
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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