Bilateral Asymmetrical Erector Spinae Catheters Analgesia Versus Thoracic Epidural Catheter Analgesia in Minimally Invasive Oesophageal Cancer Surgery: a Randomized Controlled Trial
试验速览
- 阶段
- 不适用
- 状态
- 尚未招募
- 发起方
- 入组人数
- 50
- 主要终点
- Morphine consumption
研究概览
简要总结
For esophagectomy, peri-operative continuous thoracic epidural analgesia (TEA) is the standard of care for perioperative pain management. Although effective, TEA is associated with moderate to serious adverse events such as hypotension and neurologic complications. Peri-operative continuous Erector spinae analgesia (ESP) may be a safe alternative. The Investigators hypothesize that TEA and ESP are similar in efficacy for pain treatment in thoracolaparoscopic esophagectomy with less side effects.
Methods. This Randomized prospective randomized study will compare TEA (Which is a wellknown technique of regional anaesthesia with numerous publications) with ESP ( Which is a technique of regional anaesthesia described in 2016 and with already 1000 publication) in a consecutive series of 50 thoracolaparoscopic esophagectomies randomized in 2 groups study groups ESP and controled group TEA.
In this study,
- The TEA will consist of continuous epidural ropivacaine and sufen- tanil infusion with an induction dose for the surgery and a programmed intermittent bolus (PIB) started at the end of the surgery and ended 72h after the end of the surgery.
- The ESP; the Bilateral catheters will be inserted under ultrasound guidance after the anaesthesia induction with an induction dose and a PIB started at the end of the surgery and ended 72h after the end of the surgery.
The primary outcome will be the median highest recorded Visual Analogic Scale (VAS) during the 3 days after surgery.
The secondary outcomes will be vaso-pressor consumption, fluid administration, and length of hospital stay.
详细描述
For this single-center Prospective randomized controlled study, with the Approval of Ethical committee of VinMec Healthcare and after Patient's information waived the need for informed consent. The performance and reporting of this study will be in accordance with the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines.
Investigators are hypothesizing that intra-operative and post operative Thoracic Epidural analgesia (TEA) or Erector Spinae Plane analgesia (ESP) are similary effective with regard to quality of analgesia in Thoraco Laparoscopic Akiyama oesophagectomy for cancer.
Patients, listed for this type of surgery,after information and signed consent will be randomized via a random number generator into one of two treatment groups by the person who obtained consent which is prescribed in the nurse preparation file".
• Group 1 = Control group will have peri-operative analgesia by standard Continuous TEA. The TEA performance and epidural insertion will be performed just before the anesthesia induction as per guidelines in regional anesthesia. the tip of the epidural cathter should be at the level of the thoracic vertebra (T) 7. Puncture point at level T9
Volume of ropivacaine 0.5% Patient height:
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Treatment
- 盲法
- Single (Participant)
盲法说明
This is a single centered, open label, randomized controlled trial
入排标准
- 年龄范围
- 18 Years 至 70 Years（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Patients who are diagnosed with esophageal cancer and scheduled to for TLE using Akiyama technique,
- •Informed and signed the consent
排除标准
- •patient refusal,
- •allergy to local anesthetic (LA),
- •complex congenital malformation,
- •mental deficit,
- •substance abuse (alcohol, opioids, etc.)
- •renal insufficiency
结局指标
主要结局
Morphine consumption
时间窗: 72 hours
mg morphine
次要结局
- Extension of sensory blockade(72hours)
- Side effects(72hours)
- quality of recovery(1 week)
研究者
Philippe Macaire
Director of anesthesia
Vinmec Healthcare System