Thoracic Paravertebral Blockade in Video Assisted Thoracoscopic Surgery (VATS)
- Conditions
- Pain, Postoperative
- Interventions
- Drug: Patient Controlled Analgesia (IV PCA)Drug: Thoracic paravertebral block (TPVB)
- Registration Number
- NCT02302586
- Lead Sponsor
- Istanbul University
- Brief Summary
Video-assisted thoracoscopic surgeries (VATS) include severe postoperative acute pain which is also a predictor of chronic pain. In this study, the investigators aim to compare the postoperative effects of thoracic paravertebral block (TPVB) and intravenous patient controlled analgesia (PCA) on the prevention of chronic pain of patients undergoing VATS.
- Detailed Description
Video-assisted thoracoscopic surgeries (VATS) include significant postoperative acute and chronic pain because of trocar site tissue damages, intercostal nerve injuries and related inflammatory responses. Poorly controlled pain in the early postoperative period usually causes chronic pain, and also affects patients' physiotherapy, mobilization and daily function.
Our hypothesis in this study is 'thoracic paravertebral block (TPVB) is associated with an improvement in control of acute and chronic pain after VATS compared to systemic analgesia.
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 60
ASA I-III Patients who undergo Video-assisted thoracoscopic surgery (VATS) under GA
Patients with difficult understanding the instructions for using PCA and/or pain scales Patients with contraindication to regional anesthesia Patients with significant neurologic, psychiatric or cognitive disorders History of substance abuse or chronic opioid use
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Patient Controlled Analgesia (IV PCA) Patient Controlled Analgesia (IV PCA) Postoperative intravenous (IV) morphine PCA is being used for acute pain control: Basal infusion: 0.3 mg/kg/h Bolus: 1 mg, Lock-out time: 20 min, 4-h limit: 10-12,5 mg Thoracic Paravertebral Block (TPVB) Thoracic paravertebral block (TPVB) Preoperative thoracic paravertebral block (TPVB) at 4 levels from T4 to T8 is being performed and total of 20 mL Bupivacaine 0.5% is deposited (5 mL per level by using landmark technique)
- Primary Outcome Measures
Name Time Method Postoperative chronic pain scores (VAS) at rest and during mobilization Up to 6 months Chronic pain follow-up
- Secondary Outcome Measures
Name Time Method Postoperative vital signs 0-48 hours Postoperative early period hemodynamic follow-up
Postoperative acute pain at rest and during coughing/mobilization 0-48 hours Postoperative acute pain score (VAS) follow-up
Postoperative nausea and vomiting (PONV) and antiemetic requirements 0-48 hours Postoperative acute PONV and antiemetic use follow-up
Postoperative morphine consumption 0-48 hours Postoperative IV PCA morphine consumption for Group 1 and IV morphine consumption for Group 2 as rescue analgesic
Time to first analgesic 0-48 hours Postoperative first analgesic IV PCA morphine demand time for Group 1 and first rescue analgesic IV morphine time for Group 2
Postoperative first oral intake, flatulence, defecation, mobilization times 0-48 hours Postoperative first oral intake, flatulence, defecation, mobilization times
Postoperative hospital discharge day and time Participants is being followed for the duration of hospital stay, an expected average of 1 week Postoperative hospital discharge day and time
Postoperative long term (1st, 3rd and 6th months) analgesic, sleep quality and comfort follow-up Up to 6 months Postoperative long term (1st, 3rd and 6th months) analgesic, sleep quality and comfort follow-up with phone call
Trial Locations
- Locations (1)
Istanbul University, Department of Anesthesiology
🇹🇷Istanbul, Turkey