Pectoralis and Serratus Nerves Block in Thoracic Surgery

Soroka University Medical Center

Status and phase: Unknown; Phase 2

Conditions: Block; Surgery; Thoracic Injury; Anesthesia

Treatments: Procedure: Thoracotomy; Drug: Opioids; Device: Ultrasound; Drug: NSAID; Drug: Bupivacaine Hydrochloride

Study type: Interventional

Funder types: Other

Identifiers

NCT03023982

SOR 34516 CTIL

Details and patient eligibility

About

A new conceptual regional anesthesia the PECs II block (modified pectoral and serratus nerves block) has been described for pain control after thoracic surgery, one of the indications to perform this method is analgesia for surgeries or procedures involving lateral chest wall

Full description

The PECs I block was found to be very effective after breast cancer surgery and sub-pectoral prosthesis for pain control management.

This block is provided by injection into another myofascial plane, this time between pectoralis minor and serratus anterior muscle at the level of 3rd and 4th rib.PECs II block is simple in performance with a high success rate and minimal incidence of complications, especially, if used ultrasound approach that gives a good understanding of anatomy of the lateral thoracic wall.

In present clinical trial we are going to compare PECs block for pain control with traditional pain management techniques based on IV opioids and NSAIDs treatment in patient undergoing thoracic surgery in early postoperative period.

Enrollment: 168 estimated patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

1. All patients undergoing thoracic surgery, older ≥18 years
2. Patients who meet criteria of ASA I-II-III class.

Exclusion criteria

1. Patients who will be unconscious or mentally incompetent
2. Patients refusal to participate in the study
3. ASA -IV -V
4. Patient with coagulopathy
5. Hemodynamically unstable (systolic BP < 90, HR > 100)
6. Allergy to local anesthetic drugs or opioids
7. Pregnant patient
8. History of opioid abuse

Trial design

Primary purpose: Supportive Care

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Double Blind

---

168 participants in 2 patient groups

Pectoralic block group

Experimental group

Description:

After general anesthesia, 40ml of 0.25% Bupivacaine Hydrochloride will be administered before procedure Thoracotomy. Block will be administrated between pectoralis minor and serratus anterior muscle at the 3rd and 4th rib., in assistance of ultrasound for visualization anesthetic injection point.

Treatment:

Procedure: Thoracotomy

Drug: Bupivacaine Hydrochloride

Drug: NSAID

Device: Ultrasound

Drug: Opioids

Control group

Active Comparator group

Description:

Patients in this group will receive standard pain control with opioids and NSAIDs

Treatment:

Procedure: Thoracotomy

Drug: NSAID

Drug: Opioids