Bi-level vs. Single Level ESB in VATS

Lawson Health Research Institute

Status: Unknown

Conditions: Acute Pain

Treatments: Procedure: Single level erector spinae block; Procedure: Bi-level erector spinae block

Study type: Interventional

Funder types: Other

Identifiers

NCT05294315

120374

Details and patient eligibility

About

Video assisted thoracoscopic surgery (VATS) is a minimally invasive surgery to remove lesions from the thoracic cavity. It is associated with moderate pain which can lead to pulmonary complications after surgery. The Enhanced Recovery After Surgery (ERAS) and the European Society of Thoracic Surgeons recommended a multimodal analgesia approach to manage pain after VATS. Erector spinae block (ESB) is a popular analgesic block due to its ease of performance and wide coverage. It has been shown to be effective in randomized control trials. Recently, case reports on bi-level ESB are emerging, suggesting more effective analgesia compared to single level ESB. As there is no available data, the investigators are interested in conducting a randomized pilot study, comparing bi-level to single level ESB to gather baseline data for sample size calculation for a formal randomized trial.

Enrollment: 90 estimated patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• adult patients (at least 18 years old)
• elective unilateral wedge resection, segmentectomy, lobectomy or bilobectomy via VATS

Exclusion criteria

• history of malignant hyperthermia
• BMI > 40, chronic pain condition
• Daily opioid consumption of more than 60 mg oral morphine equivalents
• Conversion to thoracotomy
• Insertion of epidural
• postoperative admission to ICU

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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90 participants in 2 patient groups

Single level block arm - Control

Active Comparator group

Description:

Single level erector spinae block at 4th transverse process

Treatment:

Procedure: Single level erector spinae block

Bi-level block arm - Intervention

Experimental group

Description:

Bi-level erector spinae block at 4th and 6th transverse process

Treatment:

Procedure: Bi-level erector spinae block