Comparative Study: Erector Spinae Plane Block Versus Paravertebral Plane Block Regarding Their Effect on Peri-operative Opioid Consumption in Patients Undergoing Minimally Invasive Mitral Valve Replacement .
Overview
- Phase
- Not Applicable
- Intervention
- Not specified
- Conditions
- ERAS
- Sponsor
- Ain Shams University
- Enrollment
- 80
- Locations
- 1
- Primary Endpoint
- Postoperative opioid consumption
- Status
- Completed
- Last Updated
- last year
Overview
Brief Summary
In recent years , the popularity of ultrasound-guided fascial plane blocks has increased in achieving an effective postoperative analgesia and hence achieving enhanced recovery after surgery (ERAS) .
Mastering the use of ultrasound encourages anesthetists on the frequent use of regional anesthesia . Fascial plane blocks are increasingly becoming a part of multimodal analgesia as an alternative pain management strategy in cardiac surgery. Various regional techniques especially paravertebral plane blocks have been recently described to reduce the postoperative pain in cardiac surgery with enhanced recovery . Ultrasound-guided erector spinae plane block is a recently introduced technique for regional analgesia in thoracic neuropathic pain, rib fractures, and breast surgeries. This study aims to compare between the two techniques regarding their peri-operative analgesic effect and their impact on enhanced recovery after surgery.
Detailed Description
This study aims to compare between the effectiveness of Erector spinae plane block and thoracic paravertebral plane block in reducing the perioperative need of opioids in patients undergoing minimally invasive mitral valve replacement as part of ERAS.
Investigators
Eligibility Criteria
Inclusion Criteria
- •Patients with American Society of Anesthesiologists (ASA) score III.
- •Patients aged ≥ 18 years old.
- •Patients scheduled for minimally invasive mitral valve replacement through a right mini thoracotomy.
Exclusion Criteria
- •Patients refusing to be involved in this study.
- •Patients with ASA score \> III.
- •Patients aged \< 18 years.
- •Patients with local infection at the site of needle puncture.
- •Patients with known hypersensitivity to local anesthetic (LA).
- •Patients with hepatic or renal impairment.
Outcomes
Primary Outcomes
Postoperative opioid consumption
Time Frame: For 24 hours after extubation
morphine in milligram postoperatively
intraoperative opioid consumption
Time Frame: Through intraoperative period, average of 6 hours
Fentanyl in micrograms intraoperatively
Secondary Outcomes
- Time for extubation(24 hours postoperative)
- Time for ambulation(Through the stay of the patient in ICU postoperatively, average of 2 days.)
- Postoperative respiratory depression(24 hours after extubation)
- Length of ICU stay(Through patient's stay inicu till discharge to ward, average of 3 days)