External Oblique Intercostal Plane Block Versus Thoracic Paravertebral Block for Post Thoracotomy Pain
- Conditions
- Thoracic Paravertebral BlockExternal Oblique Intercostal Plane BlockPost Thoracotomy Pain
- Interventions
- Other: External oblique intercostal plane blockOther: Thoracic paravertebral block
- Registration Number
- NCT06431880
- Lead Sponsor
- Tanta University
- Brief Summary
The aim of this study is to compare the effectiveness of analgesia achieved by external oblique intercostal plane block (EOIPB)and thoracic paravertebral block (TPVB) for postoperative pain management in patients undergoing open thoracotomy.
- Detailed Description
Acute thoracotomy pain is multifactorial in nature. It involves nociceptive and neuropathic mechanisms originating from somatic and visceral afferents. The main sources of pain are intercostal nerves, the vagus nerve and phrenic nerve in the pleura, the superficial cervical plexus, and the brachial plexus in the ipsilateral shoulder.
Recruitment & Eligibility
- Status
- RECRUITING
- Sex
- All
- Target Recruitment
- 90
- Age ≥ 18 years.
- Both sexes.
- American Society of Anesthesiology (ASA) physical status I-III.
- Scheduled for open thoracotomy
- Patients with neurological or intellectual disability.
- Infection at the injection site.
- Opioid addiction.
- Allergic reaction to local anesthetics.
- Coagulation abnormalities.
- Drug abuse.
- Pregnancy.
- Severe liver and/or renal failure.
- Uncontrolled hypertension.
- Severe cardiovascular problems.
- Diabetes mellitus.
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description External oblique intercostal plane block External oblique intercostal plane block Patients will receive external oblique intercostal plane block. Thoracic paravertebral block Thoracic paravertebral block Patients will receive thoracic paravertebral block.
- Primary Outcome Measures
Name Time Method Total morphine consumption 24 hours postoperatively Rescue analgesia of morphine will be given as 2 mg bolus if the numeric rating scale (NRS) \> 3 to be repeated after 30 min if pain persists until the numeric rating scale \< 4. numeric rating scale will be assessed at 0, 4, 8, 12, 18 and 24h postoperatively.
- Secondary Outcome Measures
Name Time Method Mean arterial pressure Till the end of surgery Mean arterial pressure will be recorded preoperative, before performing of block, and every 15 min till the end of surgery.
Degree of pain 24 hours postoperatively Degree of pain will be measured using numeric rating scale (NRS) (0 represents "no pain" while 10 represents "the worst pain imaginable").NRS will be assessed at 0, 4, 8, 12, 18 and 24h postoperatively.
Heart rate Till the end of surgery Heart rate will be recorded preoperative, before performing of block, and every 15 min till the end of surgery.
Time to the 1st rescue analgesia 24 hours postoperatively All patients will receive paracetamol 1 gm every 6 h as routine analgesia. Rescue analgesia of morphine will be given as 2 mg bolus if the numeric rating scale \> 3 to be repeated after 30 min if pain persists until the numeric rating scale \< 4. NRS will be assessed at 0, 4, 8, 12, 18 and 24h postoperatively
Intraoperative fentanyl consumption Intraoperative Additional fentanyl bolus dosages of 1 µg/kg IV will be administered if heart rate or mean arterial blood pressure elevated more than 20% of the baseline (after exclusion of other causes than pain).
Complications 24 hour postoperatively Complications such as bradycardia, hypotension, nausea, vomiting, respiratory depression, local anesthetic systemic toxicity (LAST) or any other complication will be recorded.
Trial Locations
- Locations (1)
Tanta University Hospitals
🇪🇬Tanta, El-Gharbia Governorate, Egypt, Egypt