Analgesic Efficacy of Pre-emptive Ultrasound-Guided Mid-Point Transverse Process to Pleura Block for Patients Undergoing Posterolateral Thoracotomy Incisions: Randomized Controlled Trial
Overview
- Phase
- Not Applicable
- Intervention
- Not specified
- Conditions
- Pre-emptive
- Sponsor
- Tanta University
- Enrollment
- 70
- Locations
- 1
- Primary Endpoint
- The degree of Postoperative Pain
- Last Updated
- 4 years ago
Overview
Brief Summary
This study is designed to investigate the analgesic efficacy of pre-emptive ultrasound-guided midpoint transverse process to pleura (MTP) block for posterolateral thoracotomy in cardiothoracic surgeries.
Detailed Description
Preemptive preoperative analgesia was first proposed, over the years it has been gradually regarded as an intervention given before incision, facilitating mobilization and functional rehabilitation after surgery, reducing postoperative opioid consumption, decreasing the incidence of adverse events and improving patient satisfaction. The Mid Transverse Process to Pleura block, described by Costach et al. involves deposition of drug midway between the transverse process and pleura. Costach et al. postulated that the local anesthetic deposited at this point may reach the paravertebral space through several possible mechanisms, such as spread medially through the gap between the superior costotransverse ligament (SCTL) and vertebral bodies, through fenestrations in SCTL, and laterally through the internal intercostal membrane
Investigators
Heba Abdelhamid Mohamed
Resident of Anesthesiology and Surgical Intensive Care and Pain Medicine
Tanta University
Eligibility Criteria
Inclusion Criteria
- •Patients aged 21- and65 years old
- •American Society of Anesthesiologists (ASA) II-III
- •Scheduled for posterolateral thoracotomy operation under general anesthesia
Exclusion Criteria
- •Patients with bleeding disorders,
- •Mental or cognitive dysfunction
- •History of chronic analgesic or drug abuse
- •Allergy to local anesthetics
- •Local infection at site of block
Outcomes
Primary Outcomes
The degree of Postoperative Pain
Time Frame: 24 hours postoperative
Postoperative pain will be assessed by the Numerical Rating Scale (NRS;0 no pain while 10 is the maximum pain) at 0,4,8,12,18, 24 hours during rest and cough. If the (NRS) is 4 or more, morphine 3mg will be titrated until pain relief is achieved using a short interval between boluses
Secondary Outcomes
- The amount of Postoperative morphine consumption(24 hours Postoperative)
- Time to the first rescue analgesia request(24 hours Postoperative)
- SpO2/FiO2 ratio(24 hours Postoperative)