- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT03749395
Ultrasound Guided Erector Spinae Block for Postoperative Analgesia in Thoracotomy Patients
August 16, 2020 updated by: mohammed gomaa sobhy, Benha University
Ultrasound Guided Erector Spinae Block for Postoperative Analgesia in Thoracotomy Patients : A Prospective, Randomized, Observer-Blind,Controlled Clinical Trial
aim of this study is to assess and compare between the efficacy of the new U/S guided erector spinae plane block (ESP) and the conventional methods of systemic analgesics in adult patients scheduled for elective thoracotomy surgery.
Study Overview
Status
Completed
Conditions
Intervention / Treatment
Detailed Description
Thoracotomy is considered the most painful of surgical procedures and providing effective analgesia is the onus for all anesthetists.
Ineffective pain relief impedes deep breathing, coughing, and remobilization culminating in atelectasis and pneumonia.The erector spinae plane (ESP) block is a newly-described technique for treating thoracic pain, and has several advantages that make it an attractive alternative to these more invasive procedures.Ultrasound guided erector spinae (ESP) block is a regional anesthesia technique, recently described by (Forero; et al.) for use in thoracic neuropathic pain.
ESP block is reported to lead to analgesic effect on somatic and visceral pain by effecting the ventral rami and rami communicantes that include sympathetic nerve fibers, as LA spreads through the paravertebral space .
When performed bilaterally it has been reported to be as effective as thoracic epidural analgesia.ESP block leads to effective postoperative analgesia when performed at T 4-5 level for breast and thoracic surgery.
The ESP block , will be performed as follow:The patient will be placed in a sitting position and the ultrasound probe will be placed in a longitudinal orientation 3 cm lateral to the T5 spinous process.
Three muscles were identified superficial to the hyperechoic transverse process shadow as follows: trapezius, rhomboid major, and erector spinae .
the needle will be inserted in a cephalad-to-caudad direction until the tip lay deep to erector spinae muscles, as evidenced by visible linear spread of fluid beneath muscle upon injection .
A total of 20 mL of 0.25% bupivacaine will be injected here.
Study Type
Interventional
Enrollment (Actual)
60
Phase
- Not Applicable
Contacts and Locations
This section provides the contact details for those conducting the study, and information on where this study is being conducted.
Study Locations
-
-
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Banhā, Egypt, 13518
- Banha university hospital
-
-
Participation Criteria
Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.
Eligibility Criteria
Ages Eligible for Study
18 years and older (ADULT, OLDER_ADULT)
Accepts Healthy Volunteers
No
Genders Eligible for Study
All
Description
Inclusion Criteria:
- patients aged >18 years
- American Society of Anesthesiologists Physical Status I or IV scheduled for elective thoracotomy
Exclusion Criteria:
- Refusal of the patient to provide written consent
- history of relevant drug allergy
- age less than 18
- obesity BMI > 40 kg/m2
- infection of the skin at the site of needle puncture area
- coagulopathy
- Pregnant females
Study Plan
This section provides details of the study plan, including how the study is designed and what the study is measuring.
How is the study designed?
Design Details
- Primary Purpose: PREVENTION
- Allocation: RANDOMIZED
- Interventional Model: PARALLEL
- Masking: SINGLE
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
ACTIVE_COMPARATOR: Erector Spinae Plane Block group
|
The patient will be placed in a sitting position and the ultrasound probe will be placed in a longitudinal orientation 3 cm lateral to the T5 spinous process.
Three muscles were identified superficial to the hyperechoic transverse process shadow as follows: trapezius, rhomboid major, and erector spinae .
the needle will be inserted in a cephalad-to-caudad direction until the tip lay deep to erector spinae muscles, as evidenced by visible linear spread of fluid beneath muscle upon injection .
A total of 20 mL of 0.25% bupivacaine will be injected here.
|
NO_INTERVENTION: Conventional group
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
24 hours morphine consumption
Time Frame: 24 hours postoperative
|
total morphine consumption in both groups will be assessed in the postoperative period
|
24 hours postoperative
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
The quality of analgesia based on visual analogue scale (VAS) pain scores.
Time Frame: every 6 hours for 24 hours
|
VAS score will be obtained in the postoperative period at preset time intervals.Using a ruler, the score is determined by mea-suring the distance (mm) on the 10-cm line between the "no pain" anchor and the patient's mark, providing a range of scores from 0-100.
A higher score indicates greater pain intensity.No pain (0-4 mm), mild pain(5-44 mm), moderate pain (45-74 mm), and severe pain (75-100 mm).
|
every 6 hours for 24 hours
|
Side effects of opioid usage
Time Frame: 2, 6, 12, 24 hours postoperative
|
Any evidence of opioid-related morbidity or adverse effects eg.
nausea,vomiting,pruritus.These effects will be assessed by questionnaire.
|
2, 6, 12, 24 hours postoperative
|
Procedural morbidity
Time Frame: 2, 6, 12, 24 hours postoperative
|
Any evidence of procedure-related morbidity
|
2, 6, 12, 24 hours postoperative
|
Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Sponsor
Publications and helpful links
The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.
Study record dates
These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.
Study Major Dates
Study Start (ACTUAL)
December 5, 2018
Primary Completion (ACTUAL)
November 5, 2019
Study Completion (ACTUAL)
November 5, 2019
Study Registration Dates
First Submitted
November 13, 2018
First Submitted That Met QC Criteria
November 17, 2018
First Posted (ACTUAL)
November 21, 2018
Study Record Updates
Last Update Posted (ACTUAL)
August 18, 2020
Last Update Submitted That Met QC Criteria
August 16, 2020
Last Verified
August 1, 2020
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- Erector Spinae Block
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
No
Studies a U.S. FDA-regulated device product
No
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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