Different Positions on the Diffusion and Blockade Effect of Ultrasound-guided Erector Spinae Plane Block

Not Applicable

Completed

• Conditions: Erector Spinea Plane Block
• Interventions: Other: Alteration of patients' position after erector spinae plane block

• Registration Number: NCT06142630
• Lead Sponsor: Nanjing First Hospital, Nanjing Medical University

Brief Summary

After the completion of erector spinae plane block, the patient maintains different positions to assess the diffusion of local anesthetic and the effect of the block.

Detailed Description

Eighty-four patients were selected to undergo CT guided puncture localization of pulmonary nodules under local anesthesia, and the patients were divided into groups using a computer-generated random number in a ratio of 1:1:1. To ensure objectivity, a nurse who was not involved in the study prepared a sealed opaque envelope containing grouping information. Randomly divide patients into three groups: supine position group (S group, 28 patients), prone position group (P group, 28 patients), and lateral position group (L group, 28 patients). The patients underwent ultrasound guided ESPB on the puncture side before CT puncture localization. Ultrasound guided ESPB method: Using an ultrasound high-frequency linear array probe (5-13MHz, Sonosite, USA), the probe is placed parallel to the spine on the surface of the transverse process tip of the seventh thoracic vertebrae. Under ultrasound, the transverse process and spinal muscles are clearly exposed. Then, a short inclined plane puncture needle is used, and the needle is inserted from the head side using in-plane technology. After the needle tip reaches between the transverse process and erector spinae muscles, 1ml of physiological saline is injected using water separation technology to confirm the position of the needle tip, Then inject 30ml of local anesthetic solution (0.75% ropivacaine 15ml+iohexol 15ml). After the block was completed, patients in Group S remained in a supine position; Patients in group L maintained the blocking side above; Patients in Group P maintained a prone position. After 30 minutes of block completion, CT scan and puncture localization were performed, following with 3D reconstruction. The primary outcome was LA-contrast spread to the paravertebral space.The second outcomes were as follow: 1. spread to the neural foramina 2. cranio-caudal spread 3. spread to the epidural space 4. spread to the intercostal space.

Study Timeline

• Study First Submitted: 2023-10-26
• Study First Submitted QC: 2023-11-16
• Study Start: 2023-11-21
• Study First Posted: 2023-11-21
• Primary Completion: 2024-03-15
• Status Verified: 2024-08
• Study Completion: 2024-12-01
• Last Update Submitted: 2025-02-06
• Last Update Posted: 2025-02-10

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 84

Inclusion Criteria

Patients received CT guided puncture localization of pulmonary nodules under local anesthesia

Exclusion Criteria

1. Allergic to local anesthetic
2. History of opioid abuse
3. Severe skin infection
4. Peripheral neuropathy
5. Dysfunction of blood coagulation

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Lateral position group	Alteration of patients' position after erector spinae plane block	Patient remained in a lateral position
Prone group	Alteration of patients' position after erector spinae plane block	Patient remained prone

Primary Outcome Measures

Name	Time	Method
Incidence and number of local anesthetic diffusion segment into the paravertebral space	30 minute after completion of the ESPB block	Observation of local anesthetic spread spread into the paravertebral space with CT by a researcher who was blinded to group allocation

Secondary Outcome Measures

Name	Time	Method
Sensory loss of cold	30 minute immediately after completion of the nerve block	The extent of sensory loss was assessed with cold stimulation, including the anterior chest wall (midclavicular line), lateral chest wall (posterior axillary line), and posterior chest wall (paraspinal zone) by a researcher who was blinded to group allocation
Diffusion of local anesthetic into intercostal space	30 minute after completion of the block	The diffusion of local anesthetics to intercostal space was observed with CT by a researcher who was blinded to group allocation
Diffusion of local anesthetic into the epidural space	30 minute after completion of the block	Incidence and segment of local anesthetic spread into the epidural was assessed by a researcher who was blinded to group allocation

Trial Locations

Locations (1)

Nanjing First Hospital; 🇨🇳 Nanjing, Nanjing, China