A Comparative Study of the Analgesic Effect of Ultrasound-guided Erector Spinae Plane Block Versus Serratus Anterior Plane Block for Thoracoscopic Sympathectomy Surgeries
试验速览
- 阶段
- 不适用
- 入组人数
- 110
- 试验地点
- 2
- 主要终点
- The total analgesic consumption
研究概览
简要总结
- Thoracic incisions are painful and associated with chronic post-surgical pain and inadequate analgesia is associated with poorer postoperative outcomes. Recent progress has been made in the field of thoracic anesthesia by improving analgesic modalities such as PECS 1 and PECS 2, intercostal plane block, paravertebral regional anesthesia, ultrasound-guided erector spinae and serratus anterior plane block.
- Administered of the local anesthetic in erector spinae plane block is in the interfascial plane between the transverse process of the vertebra and the erector spinae muscles, spreading to multiple paravertebral spaces. It affects both the ventral and dorsal rami and leading to blockage of both visceral and somatic pain.
- Ultrasound-guided serratus anterior plane block is a facial plane block that provides analgesia by blocking of lateral branches of intercostal nerves above or below the serratus plane muscle.
- We hypothesize that the ultrasound-guided erector spinae plane block may have better quality than the serratus anterior plane block for patients undergoing thoracoscopic sympathectomy as erector spinea plane blocks visceral and somatic pain.
详细描述
Primary palmar hyperhidrosis (PPH) refers to the excessive secretion of exocrine glands on the palms, which is often accompanied by the head, face, or plantar hyperhidrosis. PPH demonstrates no obvious organic cause; however, some patients may feel distressed because their palms sweat more than normal, and such a situation may lead to severe psychological, social, and occupational dysfunction.
Endoscopic thoracic sympathectomy abolishes eccrine sweating in all areas supplied by the postganglionic fibers with its complications which include post-sympathetic neuralgia which is the most important, wound infection, hemorrhage, pneumothorax, horner syndrome, no response to the operation and compensatory hyperhidrosis in non-denervated areas.
Forero described ultrasound-guided erector spinae plane block for treatment of thoracic neuropathic pain and explained it as a peri-paravertebral regional anesthesia technique that has been used for prevention of postoperative pain in various surgeries.
Ultrasound-guided serratus anterior plane block is a facial plane block which provides analgesia by blocking of lateral branches of intercostal nerves above or below the serratus plane muscle. There are few cases and studies in the literature reporting successful analgesia provided by serratus anterior plane block
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Supportive Care
- 盲法
- Single (Participant)
盲法说明
Single-blind (participant) study
入排标准
- 年龄范围
- 21 Years 至 40 Years（Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •American Society of Anesthesiologists grade I or II physical status
排除标准
- •Patients who had coagulopathies
- •local infections
- •neuropathies
- •neuromuscular disease
- •psychiatric disease
- •history of thoracic surgery
- •history of allergy to local anesthetics.
- •receiving chronic analgesic therapy
- •drug abusers
结局指标
主要结局
The total analgesic consumption
时间窗: 1st 24 hours after surgery
cumulative consumption of opioids during the first postoperative day
次要结局
- The total amount of fentanyl consumption(1st 24 hours after surgery)
- Duration of analgesia(within 24 hours after surgery)
- Nausea(1st 24 hours after surgery)
- mean blood pressures(Intraoperative (every 10 minutes till the end of surgery))
- Vomiting(1st 24 hours after surgery)
- systolic blood pressure(Intraoperative (every 10 minutes till the end of surgery))
- diastolic blood pressures(Intraoperative (every 10 minutes till the end of surgery))
- Postoperative severity of the pain(every 2 hours for 12hours and then at 16, 20 and 24 hours postoperatively)
- The total amount of paracetamol consumption(1st 24 hours after surgery)
- Peripheral oxygen saturation(Intraoperative (every 10 minutes till the end of surgery))
- Patient Satisfaction(After 12 and 24 hours after surgery)
- Heart rate(Intraoperative (every 10 minutes till the end of surgery))
- End-tidal carbon dioxide tension(Intraoperative (every 10 minutes till the end of surgery))