Evaluation of Post-operative Pulmonary Function After Open Kidney Surgery: Comparison Between Thoracic Epidural and Paravertebral Block
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 50
- 试验地点
- 1
- 主要终点
- vital capacity
研究概览
简要总结
To assess the respiratory and analgesic effects of continuous thoracic paravertebral block versus thoracic epidural in patients undergoing kidney surgery
详细描述
Study tools
- An Ultrasound machine (Madison X6) with superficial linear and curved probe.
- A 19 gauge echogenic needle and Plexolong Cather (PAJUNK, Plexolong Meier nanoline, Geisingen, Germany; 60 mm).
- A 17-gauge Tuohy needle and 19 G flex-tip catheter: for thoracic epidural.
- Spirometer: (Enraf-Nonius, Model SPIRO 601).
- Drugs: isobaric bupivacaine 0.25% (aside from the drugs used in the standard operation theatre).
- Computer software: computer generated random tables (for randomization) and SPSS 22 (for data analysis)
Thoracic epidural (TEP):
A pre-procedural ultrasound examination will be done to first identify the correct targeted thoracic level. To accomplish this, the transducer will be placed in the parasagittal plane approximately 5 cm from midline. The thoracic level will be determined by identifying the 12th rib and counting in a cephalad direction until the targeted level is marked.
All epidurals will be performed under all aseptic precautions with a 17-gauge Tuohy needle and 19 G flex-tip catheters. Using the loss of resistance to saline technique, catheters will be inserted 4 cm into the epidural space and a suitable test dose will be administered to exclude intravascular or sub-arachnoid injection
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Prevention
- 盲法
- Triple (Participant, Care Provider, Outcomes Assessor)
入排标准
- 年龄范围
- 18 Years 至 60 Years（Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •ASA II, III
- •elective kidney surgery
排除标准
- •patient refusal
- •contraindications to neuraxial blocks
- •pneumonectomy
- •planed postoperative mechanical ventilatoin
研究组 & 干预措施
thoracic epidural group
patients in this group will receive ultrasound guided thoracic epidural block preoperatively for pain management, continuous infusion of 0.5% bupivacaine through epidural catheter during operation and early post-operative period
干预措施: thoracic epidural block (Procedure)
paravertebral group
patients in this group will receive ultrasound guided pararvertebral block preoperatively for pain management, continuous infusion of paravertebral bupivacaine 0.5% through paravetebral catheter during operation and early post-operative period
干预措施: paravertebral block (Procedure)
结局指标
主要结局
vital capacity
时间窗: 24 hours after operation
measured by spirometer (Enraf-Nonius, Model SPIRO 601 medical Technologies)
forced vital capacity
时间窗: 24 hours after operation
measured by spirometer (Enraf-Nonius, Model SPIRO 601 medical Technologies)
forced expiratory volume in one second
时间窗: 24 hours after operation
measured by spirometer (Enraf-Nonius, Model SPIRO 601 medical Tecnologies)
次要结局
- diaphragmatic excursion(24 hours after operation)
- pain score(24 hours after operation)
研究者
Khaled Abdelbaky Abdelrahman
Assistant professor
Assiut University