TEA, ESB and Paravertebral Block During Single-lung Ventilation for Lung Resection

South Egypt Cancer Institute

Status: Enrolling

Conditions: Lung Diseases; Pain, Acute

Treatments: Procedure: paravertebral block anesthesia; Procedure: Thoracic epidural anesthesia; Procedure: erector spinae block

Study type: Interventional

Funder types: Other

Identifiers

NCT05211791

TEA in single lung ventilation

Details and patient eligibility

About

Thoracotomy operations are known to be painful surgical procedures, so providing effective intraoperative and postoperative analgesia is so important for all anaesthesiologists. Ineffective pain management interferes with deep breathing, coughing, and remobilization resulting in atelectasis and pneumonia.

Ultrasound-guided ESP block is a myofascial plane block that provides analgesia for thoracic or abdominal segmental innervation depending on the level of the injection site. Thoracic epidural analgesia (TEA) is considered the gold standard analgesic technique for thoracic surgeries. But the invasiveness of this technique, the rare but serious neurologic complications and the failure rates up to 30% are the disadvantages of epidural analgesia

Full description

The aim of this study is to compare the effect of different blocks as TEA, erector spinae block or paravertebral block on improving peri-operative analgesia and post-operative outcome in pulmonary resection in adult patients.

Enrollment: 90 estimated patients

Sex: All

Ages: 18 to 70 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• aged between 18 to 70 years old for elective lung resection. with American Society of Anesthesiology physical status (ASA-PS) I-III

Exclusion criteria

• Total pneumonectomy
• Hepatic or renal dysfunction.
• contraindications for epidural anesthesia as Coagulopathy and neurological and spinal deficits.
• emergency cases

Trial design

Primary purpose: Prevention

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Triple Blind

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90 participants in 3 patient groups

Group TEA

Active Comparator group

Description:

insertion of Thoracic epidural anesthesia plus GA with lung isolation using suitable size double lumen tube at level T6

Treatment:

Procedure: Thoracic epidural anesthesia

Group ESB

Active Comparator group

Description:

U/S guided erector spinae block anesthesia using 15 ml local anesthesia plus GA with lung isolation using a suitable size double-lumen tube

Treatment:

Procedure: erector spinae block

Group PVB

Active Comparator group

Description:

U/S guided paravertebral block anesthesia using 15 ml local anesthesia as total volume plus GA with lung isolation using suitable size double lumen tube

Treatment:

Procedure: paravertebral block anesthesia