Different Positions on the Diffusion and Blockade Effect of Ultrasound-guided Erector Spinae Plane Block

Nanjing Medical University

Status: Enrolling

Conditions: Erector Spinea Plane Block

Treatments: Other: Alteration of patients' position after erector spinae plane block

Study type: Interventional

Funder types: Other

Identifiers

NCT06142630

KY20230915-04

Details and patient eligibility

About

After the completion of erector spinae plane block, the patient maintains different positions to assess the diffusion of local anesthetic and the effect of the block.

Full description

Eighty-four patients were selected to undergo CT guided puncture localization of pulmonary nodules under local anesthesia, and the patients were divided into groups using a computer-generated random number in a ratio of 1:1:1. To ensure objectivity, a nurse who was not involved in the study prepared a sealed opaque envelope containing grouping information. Randomly divide patients into three groups: supine position group (S group, 28 patients), prone position group (P group, 28 patients), and lateral position group (L group, 28 patients). The patients underwent ultrasound guided ESPB on the puncture side before CT puncture localization. Ultrasound guided ESPB method: Using an ultrasound high-frequency linear array probe (5-13MHz, Sonosite, USA), the probe is placed parallel to the spine on the surface of the transverse process tip of the seventh thoracic vertebrae. Under ultrasound, the transverse process and spinal muscles are clearly exposed. Then, a short inclined plane puncture needle is used, and the needle is inserted from the head side using in-plane technology. After the needle tip reaches between the transverse process and erector spinae muscles, 1ml of physiological saline is injected using water separation technology to confirm the position of the needle tip, Then inject 30ml of local anesthetic solution (0.75% ropivacaine 15ml+iohexol 15ml). After the block was completed, patients in Group S remained in a supine position; Patients in group L maintained the blocking side above; Patients in Group P maintained a prone position. After 30 minutes of block completion, CT scan and puncture localization were performed, following with 3D reconstruction. The primary outcome was LA-contrast spread to the paravertebral space.The second outcomes were as follow: 1. spread to the neural foramina 2. cranio-caudal spread 3. spread to the epidural space 4. spread to the intercostal space.

Enrollment: 84 estimated patients

Sex: All

Ages: 18 to 80 years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

Patients received CT guided puncture localization of pulmonary nodules under local anesthesia

Exclusion criteria

1. Allergic to local anesthetic
2. History of opioid abuse
3. Severe skin infection
4. Peripheral neuropathy
5. Dysfunction of blood coagulation

Trial design

Primary purpose: Prevention

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Double Blind

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84 participants in 3 patient groups

Supine group

No Intervention group

Description:

Patients remained supine

Prone group

Experimental group

Description:

Patient remained prone

Treatment:

Other: Alteration of patients' position after erector spinae plane block

Lateral position group

Experimental group

Description:

Patient remained in a lateral position

Treatment:

Other: Alteration of patients' position after erector spinae plane block