Analgesic Effect of Mid-transverse Process to Pleura Block Combined With Erector Spinae Block Versus Paravertebral Plane Block in Thoracic Surgery for Lung Cancer Patients
Overview
- Phase
- Not Applicable
- Intervention
- Mid-transverse process to pleura block combined with erector spinae block
- Conditions
- Lung Cancer
- Sponsor
- Cairo University
- Enrollment
- 60
- Locations
- 1
- Primary Endpoint
- visual analogue score changes during rest and cough for the three groups.
- Status
- Recruiting
- Last Updated
- last month
Overview
Brief Summary
This study aims to compare efficacy of Mid-transverse process to pleura block combined with erector spinae block versus paravertebral plane block in cancer patients undergoing thoracotomy surgeries.
Detailed Description
Thoracic paravertebral block (TPVB) application has also been used in recent years due to the lower incidence of side effects. The erector spinae plane block (ESPB)has been used as a part of multimodal analgesia in recent years. In ESPB is aimed to treat the postoperative pain of the thoracoabdominal region by injecting a local anesthetic into the interfacial area under the erector spinae muscle . ESPB creates an effect that covers the posterior and lateral thorax by affecting the dorsal rami and branches of the spinal nerves . Midtransverse process to pleura (MTP) block is less invasive as the position of the needle in this block is midway between the transverse process' posterior border and the pleura. Due to fenestrations present in the superior costotransverse ligament (SCTL), the drug reaches the paravertebral space
Investigators
Sayed Mahmoud Abed
assistant professor
Cairo University
Eligibility Criteria
Inclusion Criteria
- •lung cancer patients for thoracotomy surgeries.
- •Physical status American Society of Anesthesiologists (ASA )II, III.
- •Age ≥ 18 and ≤ 65 Years.
- •Body mass index (BMI): \> 20 kg/m2 and \< 35 kg/m2
Exclusion Criteria
- •Patient refusal
- •physical status ASA IV,
- •Age \<18 years or \>65 years
- •BMI \< 20 kg/m2 and \>35 kg/m2
- •Known sensitivity or contraindication to drug used in the study (local anesthetics, opioids).
- •History of psychological disorders and/or chronic pain.
- •Contraindication to regional anesthesia e.g., local sepsis, pre- existing peripheral neuropathies, and coagulopathy.
- •Severe respiratory, cardiac, hepatic or renal disease.
Arms & Interventions
Group 1:midtransverse to pleura block combined with erector spinae block
Patients received ipsilateral Ultrasound guided midtransverse block with injection of 20 ml bupivacaine 0.25% and ipsilateral Ultrasound guided ESPB block with injection of 20 ml bupivacaine 0.25%
Intervention: Mid-transverse process to pleura block combined with erector spinae block
Group 2: paravertebral block
Patients received ipsilateral Ultrasound guided paravertebral plane block with injection of 30 ml bupivacaine 0.25%.
Intervention: paravertebral block
Outcomes
Primary Outcomes
visual analogue score changes during rest and cough for the three groups.
Time Frame: for 24 hours postoperative
the score of visual analogue score, with minimum score of 0 and maximum of 10, with higher scores meaning more severe pain