Comparison of Ultrasound-guided Approach and Ultrasound-guided Approach Combined With Pressure Measurement Technique to Thoracic Paravertebral Block for Open Thoracotomy
试验速览
- 阶段
- 不适用
- 入组人数
- 72
- 试验地点
- 2
- 主要终点
- visual analogue scale for pain (VAS) at 2 hour after the arrival of postanesthetic care unit (PACU)
研究概览
简要总结
Posterolateral thoracotomies are among the most painful procedures of surgery and may cause severe postoperative chest pain and impaired respiratory performance. Paravertebral block (PVB) is an established method of administering postoperative analgesia for thoracic procedures. PVB blocks the somatic and sympathetic nervous systems and is placed by injecting a local anesthetic (LA) into the paravertebral space where the nerve and its branches are located after exiting the intervertebral foramen. But previous study showed 5-10% of failure rate in PVB using ultrasound machine. Pressure measurement during needle advancement could improve reliability of correct needle placement. When the needle tip reaches paravertebral space, there is a sudden lowering of pressures due to respiratory cycle. Therefore, sensitivity and specificity could be improved and correct needle placement become objective and reproducible when PVB using ultrasound is combined with pressure measurement during needle advancement.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Treatment
- 盲法
- Double (Participant, Outcomes Assessor)
入排标准
- 年龄范围
- 19 Years 至 85 Years（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Scheduled for elective thoracotomy
- •ASA status 1,2
排除标准
- •Inability to provide adequate informed consent
- •Any contraindication to the placement of thoracic paravertebral catheters
- •Unstable vertebral and transverse process fractures
- •Any chronic painful conditions or preoperative opioid use Any chronic painful conditions or preoperative opioid use
- •Coagulation abnormalities or expectation to be on therapeutic anticoagulants postoperatively
- •Allergy to any of the drugs/agents used in study protocol
- •Altered mental status or emergency surgery
- •Comorbid conditions such as sepsis, unstable angina, congestive heart failure
研究组 & 干预措施
ultrasound group
The participants have continuous thoracic paravertebral block performed using only the ultrasound approach.
pressure measurement group
The participants have continuous thoracic paravertebral block performed using the ultrasound-guided approach combined with pressure measurement techniqueduring needle advancement.
干预措施: thoracic paravertebral block using pressure measurement technique (Procedure)
结局指标
主要结局
visual analogue scale for pain (VAS) at 2 hour after the arrival of postanesthetic care unit (PACU)
时间窗: 2 hour after the arrival of PACU
VAS score is measured at 2 hour after a patient arrives in PACU. The pain VAS is a unidimensional measure of pain intensity. The pain VAS is a continuous scale comprised of a horizontal (HVAS) line, usually 10 centimeters (100 mm) in length, anchored by 2 verbal descriptors, one for each symptom extreme (no pain 0, maximal pain 100).
次要结局
未报告次要终点
研究者
Sangjin Park
professor
Yeungnam University College of Medicine