- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT04299035
ESP Block vs. Traditional Pain Management for ERAS
Erector Spinae Plane Block Versus Traditional Pain Management for Enhanced Recovery After Surgery
Patients undergoing thoracotomy, thoracoscopy or other surgical procedures involving the integrity of the chest wall are always in a special point of interest of both surgical and anesthesiological specialities. Most of the patients will describe the pain after thoracic surgery as severe. It might lead to a number of serious complications: respiratory failure due to splinting; inability to clear secretions by effective coughing, with resulting pneumonia; and turning into a chronic pain: the post-thoracotomy pain syndrome.
Traditional pain management in these groups of patients - such as opiate treatment, thoracic epidural analgesia, and non-opioid drugs - may have serious side effects. Large doses of opiates suppress the cough reflex and lead to respiratory depression with subsequent re-intubation and re-ventilation. Thoracic epidural analgesia, though being considered paramount among other analgesic options, requires a significant clinical experience. Still, it might be insufficient for satisfactory pain control and even complicated with pneumothorax, total spinal anaesthesia and inadvertent intravascular injection. Non-steroidal anti-inflammatory drugs (NSAIDs) and Tramadol are weak analgesics inadequate for severe pain control and might be responsible for gastrointestinal bleeding.
We suggest performing erector spinae plane block for intraoperative and postoperative pain management due to the ease of use and better analgesic effect. What remains is hard proof for the clinical efficacy and safety of this block, followed by a demonstration of the uptake of it in the hands of non-regional anaesthetists.
Study Overview
Status
Conditions
Intervention / Treatment
Study Type
Enrollment (Anticipated)
Phase
- Phase 3
Contacts and Locations
Study Contact
- Name: Dmitry Natanel, MD
- Phone Number: +972533360451
- Email: nataneld@bgu.ac.il
Study Contact Backup
- Name: Michael Dubilet, MD
- Email: michaeldu@clalit.org.il
Study Locations
-
-
-
Beersheba, Israel
- Recruiting
- SorokaUMC
-
Contact:
- Dmitry Natanel, MD
- Phone Number: 0533360451
- Email: nataneld@bgu.ac.il
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- all consecutive adult patients who undergo thoracic, spinal or abdominal surgery in Soroka Medical Center, and agree to participate in the study, older than 18 years, who meet criteria of ASA physical status I-II-III-IV class.
Exclusion Criteria:
- Unconscious or mentally incompetent patients or those who refuse to participate in the study.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Single
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Thoracic surgery + ESPblock
Thoracic surgery + ESPblock + standard pain management
|
Erector spinae plane block
|
Experimental: Abdominal surgery + ESPblock
Abdominal surgery + ESPblock + standard pain management
|
Erector spinae plane block
|
Experimental: Spinal surgery + ESPblock
Spinal surgery + ESPblock + standard pain management
|
Erector spinae plane block
|
No Intervention: Thoracic surgery
Thoracic surgery + standard pain management
|
|
No Intervention: Abdominal surgery
Abdominal surgery + standard pain management
|
|
No Intervention: Spinal surgery
Spinal surgery + standard pain management
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Visual Analog Pain Score
Time Frame: 3 days
|
Reported immediate postoperative VAS score, up to 3rd day
|
3 days
|
Total pain med consumption in the PACU
Time Frame: 3 hours
|
Total Morphine, NSAIDs and Tramadol amount (mg) in the PACU
|
3 hours
|
Length of stay in the PACU
Time Frame: 24 hours
|
Length of stay in postoperative care room
|
24 hours
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Length of hospital stay
Time Frame: 30 days
|
Length of hospital stay
|
30 days
|
Chronic pain development
Time Frame: 6 months
|
Rate of chronic pain at 3 and 6 months after surgery
|
6 months
|
Collaborators and Investigators
Sponsor
Investigators
- Principal Investigator: Michael Dubilet, MD, Soroka University Medical Center
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Anticipated)
Study Completion (Anticipated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- 0355-19-SOR
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
product manufactured in and exported from the U.S.
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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