Effect of Patient Position on Dermatomal Spread and Analgesic Outcomes of Erector Spinae Plane Block in Thoracic Surgery: A Prospective Randomized Clinical Trial
试验速览
- 阶段
- 不适用
- 状态
- 尚未招募
- 发起方
- 入组人数
- 90
- 主要终点
- Dermatomal sensory spread
研究概览
简要总结
The erector spinae plane (ESP) block is a widely used regional anesthesia technique for postoperative analgesia in thoracic surgery. The block can be performed in different patient positions, most commonly sitting or lateral decubitus, but the effect of patient position on dermatomal sensory spread and analgesic efficacy has not been clearly established.
This prospective, randomized, single-blind clinical trial aims to compare the effects of ESP block performed in sitting versus lateral decubitus position on dermatomal sensory distribution and postoperative analgesic outcomes in patients undergoing video-assisted thoracic surgery.
详细描述
Adult patients scheduled for elective video-assisted thoracic surgery will be randomly assigned to receive ultrasound-guided unilateral erector spinae plane block either in the sitting position or in the lateral decubitus position. In both groups, the block will be performed at the same thoracic level using 30 mL of 0.25% bupivacaine under ultrasound guidance.
Dermatomal sensory spread will be assessed 15 minutes after block placement using cold sensation (alcohol-soaked cotton) and pin-prick testing. Postoperative analgesia will be standardized in all patients using patient-controlled analgesia with tramadol. Pain scores and opioid consumption will be recorded during the first 24 postoperative hours.
The primary outcome is the extent of dermatomal sensory spread. Secondary outcomes include postoperative pain scores, time to first rescue analgesic, and total opioid consumption within 24 hours.
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 75 Years（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Age 18 to 75 years
- •ASA physical status II-IV
- •Scheduled for elective video-assisted thoracic surgery
- •Ability to provide written informed consent
排除标准
- •Known allergy to local anesthetics
- •Chronic opioid use
- •Preexisting chronic pain
- •Severe cognitive impairment
- •Technical difficulty with positioning
- •Emergency surgery
- •Refusal to participate
研究组 & 干预措施
Sitting Position Group
Intervention: Erector Spinae Plane Block Ultrasound-guided unilateral erector spinae plane block performed in the sitting position using 30 mL of 0.25% bupivacaine.
干预措施: Erector Spinae (ESP) Block with Bupivacaine (Marcaine®) sitting position (Drug)
Lateral Decubitus Position Group
Intervention: Erector Spinae Plane Block Ultrasound-guided unilateral erector spinae plane block performed in the lateral decubitus position (operative side up) using 30 mL of 0.25% bupivacaine.
干预措施: Erector Spinae (ESP) Block with Bupivacaine (Marcaine®) lateral position (Drug)
结局指标
主要结局
Dermatomal sensory spread
时间窗: 15 minutes after the block application
Cranial and caudal sensory limits and total number of dermatomes affected, assessed by cold sensation and pin-prick testing.
次要结局
- Total opioid consumption(First 24 postoperative hours)
- Postoperative pain scores (Numeric Rating Scale)(Postoperative 0, 2, 6, 12, and 24 hours)
研究者
Ekin Guran, MD
Principal investigator
Dr Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital