Ultrasound-Guided Subtransverse Interligamentary Block Versus Thoracic Paravertebral Block for Postoperative Analgesia in Patients Undergoing Open Nephrectomy: A Randomized Clinical Trial
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 70
- 试验地点
- 1
- 主要终点
- Total morphine consumption
研究概览
简要总结
This study aims to compare ultrasound-guided subtransverse process interligamentary (STIL) block versus thoracic paravertebral block (TPVB) for postoperative analgesia in patients undergoing open nephrectomy.
详细描述
Acute pain physiopathology is explained as it is mediated by inflammatory cell infiltration, activation of spinal cord pain pathways, and also by reflexive muscle spasm. All of these three mechanisms of acute pain are typically ameliorated during the postoperative recovery.
A thoracic paravertebral block (TPVB) shows comparable analgesic efficacy with fewer side effects compared with thoracic epidural analgesia in patients undergoing thoracotomy.
The recently introduced subtransverse process interligamentary (STIL) block offers a safer alternative by targeting thoracic nerves without entering paravertebral space.
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
- Double (Participant, Outcomes Assessor)
入排标准
- 年龄范围
- 18 Years 至 65 Years（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Age from 18 to 65 years.
- •Both sexes.
- •American Society of Anesthesiology (ASA) physical status I-III.
- •Undergoing open nephrectomy under general anesthesia.
排除标准
- •History of allergies to local anesthetics.
- •Opioid dependency.
- •Bleeding or coagulation disorders.
- •Psychiatric and neurological disorder.
- •Local infection at the site of injection.
- •Body mass index (BMI) > 35 kg/m
- •Severe heart, lung, liver, and renal dysfunction.
- •Pregnant or lactating women.
研究组 & 干预措施
STIL group
Patients will receive subtransverse process interligamentary (STIL) block using 20ml of bupivacaine 0.25%.
干预措施: Subtransverse process interligamentary (Other)
TPVB group
Patients will receive a thoracic paravertebral block (TPVB) using 20ml of bupivacaine 0.25%.
干预措施: Thoracic paravertebral block (Other)
结局指标
主要结局
Total morphine consumption
时间窗: 48 hours postoperatively
Rescue analgesia of morphine will be given as 3 mg bolus if the numeric rating scale (NRS) \> 3 to be repeated after 30 min if pain persists until the NRS \< 4.
次要结局
- Time to the 1st rescue analgesia(48 hours postoperatively)
- Mean arterial pressure(Till the end of surgery (Up to 2 hours))
- Heart rate(Till the end of surgery (Up to 2 hours))
- Intraoperative fentanyl consumption(Intraoperatively)
- Degree of pain(48 hours postoperatively)
- Incidence of adverse events(48 hours postoperatively)
研究者
Mohammed Said ElSharkawy
Lecturer of Anesthesiology, Surgical Intensive Care and Pain Medicine, Faculty of Medicine, Tanta University, Tanta, Egypt.
Tanta University