Comparison of Pain Relief Between High Thoracic Erector Spinae Plane Block and Cervical Epidural Injection

Keimyung University

Status: Enrolling

Conditions: Pain, Chronic

Treatments: Procedure: Erector spinae plane block; Procedure: cervical epidural injection

Study type: Interventional

Funder types: Other

Identifiers

NCT05487326

2022-01-026-03

Details and patient eligibility

About

The primary endpoint of this study was to identify whether there is a pain improving effect of high thoracic eretor spinae plane block (ESPB) when compared with cervical epidural injection

Full description

The erector spinae plane block (ESPB) is a less invasive, safer, and technically easy alternative procedure to conventional neuraxial anesthetic techniques. In contrast to common neuraxial techniques such as paravertebral and epidural injections, the ESPB targets an interfascial plane which is far from the spinal cord, root, and pleura. First applied to thoracic neuropathic pain, currently ESPB is being applied to postoperative pain control and includes variable clinical situations. In the abdomen and thoracic wall, thoracic ESPB can be applied for pain control after cardiac surgery, video-assisted thoracic surgery, laparoscopic cholecystectomy, and thoracotomy. Recently, favorable postoperative pain control after lumbar spinal or lower limb surgeries has been reported with lumbar ESPB. In addition, ESPB has also been used for chronic pain conditions in the upper and lower extremities. To investigate the possible mechanism of action of the ESPB, many previous studies have focused on examining the physical spread of the injected agent. Commonly, contrast dye injections in human cadavers have been utilized to assess the spread level. Physical spread level was determined using various methods including direct dissection or sectioning, computed tomography (CT), thoracoscopic inspection, or magnetic resonance imaging (MRI) with radiocontrast injection. Apart from human cadaver studies, physical spread level has been evaluated in alive patients using a variable volume of local anesthetics mixed with radiocontrast. However, these studies are limited by the small number of included patients.

Enrollment: 82 estimated patients

Sex: All

Ages: 20 to 80 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• cervical spinal stenosis
• cervical intervertebral disc herniation
• cervical facet arthropathy
• cervical foraminal stenosis

Exclusion criteria

• Allergy to local anesthetics or contrast medium
• Pregnancy
• Spine deformity
• Patients with coagulation abnormality

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Double Blind

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82 participants in 2 patient groups

high thoracic ESPB group

Active Comparator group

Description:

Group where ESPB is performed at T2 with local anesthetic mixture 20 ml

Treatment:

Procedure: Erector spinae plane block

cervical epidural group

Active Comparator group

Description:

Group where cervical epidural injection is performed at C6-7 or C7-T1 level

Treatment:

Procedure: cervical epidural injection