Mid-transverse Process Combined With Erector Spinae Block Versus Paravertebral Plane Block

Cairo University (CU)

Status: Enrolling

Conditions: Lung Cancer

Treatments: Procedure: Mid-transverse process to pleura block combined with erector spinae block; Procedure: paravertebral block

Study type: Interventional

Funder types: Other

Identifiers

NCT06618599

analgesia in thoracotomy

Details and patient eligibility

About

This study aims to compare efficacy of Mid-transverse process to pleura block combined with erector spinae block versus paravertebral plane block in cancer patients undergoing thoracotomy surgeries.

Full description

Thoracic paravertebral block (TPVB) application has also been used in recent years due to the lower incidence of side effects. The erector spinae plane block (ESPB)has been used as a part of multimodal analgesia in recent years. In ESPB is aimed to treat the postoperative pain of the thoracoabdominal region by injecting a local anesthetic into the interfacial area under the erector spinae muscle . ESPB creates an effect that covers the posterior and lateral thorax by affecting the dorsal rami and branches of the spinal nerves . Midtransverse process to pleura (MTP) block is less invasive as the position of the needle in this block is midway between the transverse process' posterior border and the pleura. Due to fenestrations present in the superior costotransverse ligament (SCTL), the drug reaches the paravertebral space

Enrollment: 60 estimated patients

Sex: All

Ages: 18 to 65 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• lung cancer patients for thoracotomy surgeries.
• Physical status American Society of Anesthesiologists (ASA )II, III.
• Age ≥ 18 and ≤ 65 Years.
• Body mass index (BMI): > 20 kg/m2 and < 35 kg/m2

Exclusion criteria

• Patient refusal
• physical status ASA IV,
• Age <18 years or >65 years
• BMI < 20 kg/m2 and >35 kg/m2
• Known sensitivity or contraindication to drug used in the study (local anesthetics, opioids).
• History of psychological disorders and/or chronic pain.
• Contraindication to regional anesthesia e.g., local sepsis, pre- existing peripheral neuropathies, and coagulopathy.
• Severe respiratory, cardiac, hepatic or renal disease.

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Double Blind

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60 participants in 2 patient groups

Group 1:midtransverse to pleura block combined with erector spinae block

Experimental group

Description:

Patients received ipsilateral Ultrasound guided midtransverse block with injection of 20 ml bupivacaine 0.25% and ipsilateral Ultrasound guided ESPB block with injection of 20 ml bupivacaine 0.25%

Treatment:

Procedure: Mid-transverse process to pleura block combined with erector spinae block

Group 2: paravertebral block

Experimental group

Description:

Patients received ipsilateral Ultrasound guided paravertebral plane block with injection of 30 ml bupivacaine 0.25%.

Treatment:

Procedure: paravertebral block