A Randomized Clinical Trial Comparing Transverse Thoracic Plane Block, Midpoint Transverse Process Plane to Pleura Block and Erector Spinae Plane Block for Analgesia in Patients Undergoing Thoracoscopic Sympathectomy
Trial Snapshot
- Phase
- Not Applicable
- Status
- Completed
- Sponsor
- Tanta University
- Enrollment
- 60
- Locations
- 1
- Primary Endpoint
- Time to the 1st rescue analgesia
Study Overview
Brief Summary
This study compares the transversus thoracic muscle plane block (TTPB), midtransverse to pleura block (MTPB), and erector spinae plane block (ESPB) for postoperative analgesia in patients undergoing thoracoscopic sympathectomy.
Detailed Description
Thoracoscopic sympathectomy is a well-established procedure for the treatment of various hyperhidrosis disorders and certain vascular conditions, involving the division of sympathetic nerve fibers in the thoracic cavity.
The erector spinae plane block (ESPB) is an interfascial regional anesthesia block for thoracic analgesia which can be performed by superficial or deep needle approach.
The mid-transverse to pleura block (MTPB) was first described as a modified paravertebral block.
Transversus thoracic muscle plane block (TTPB) is a newly developed technique in which LA is injected into the fascial plane between the transversus thoracic muscle and the internal intercostal muscles for blocking the anterior cutaneous branches of intercostal nerves from thoracic (Th) 2 to Th 6.
Study Design
- Study Type
- Interventional
- Allocation
- Randomized
- Intervention Model
- Parallel
- Primary Purpose
- Treatment
- Masking
- Double (Participant, Outcomes Assessor)
Eligibility Criteria
- Ages
- 18 Years to 65 Years (Adult, Older Adult)
- Sex
- All
- Accepts Healthy Volunteers
- No
Inclusion Criteria
- •Age from 18 to 65 years.
- •Both sexes.
- •American Society of Anesthesiology (ASA) physical status I-II.
- •Scheduled for thoracoscopic sympathectomy
Exclusion Criteria
- •Coagulopathy.
- •History of opiate abuse.
- •Pre-existing chronic pain.
- •Allergy to local anesthetics or analgesics.
- •Infection at the site of injection.
- •Mental or neurological disorders.
- •Pregnancy
Arms & Interventions
Transverse thoracic plane block group
Patients will receive a transverse thoracic plane block.
Intervention: Transverse thoracic plane block (Other)
Midpoint transverse process plane to pleura block group
Patients will receive a midpoint transverse process plane to pleura block.
Intervention: Midpoint transverse process plane to pleura block (Other)
Erector spinae plane block group
Patients will receive an erector spinae plane block.
Intervention: Erector spinae plane block (Other)
Outcomes
Primary Outcomes
Time to the 1st rescue analgesia
Time Frame: 24 hours postoperatively
Time to the first request for the rescue analgesia (time from end of surgery to first dose of morphine administrated)
Secondary Outcomes
- Degree of patient satisfaction(24 hours postoperatively)
- Total morphine consumption(24 hours postoperatively)
- Degree of pain(24 hours postoperatively)
- Heart rate(Till the end of surgery (Up to 2 hours))
- Mean arterial pressure(Till the end of surgery (Up to 2 hours))
- Incidence of complications(24 hours postoperatively)
Investigators
Mahmoud Abdalsattar Elmohasseb
Lecturer of Anesthesiology, Surgical Intensive Care and Pain Medicine, Faculty of Medicine, Tanta University, Tanta, Egypt.
Tanta University