The Effect of Different Local Anesthetic Volumes on Postoperative Analgesia for Thoracotomy Patients With Erector Spinae Plane Block

Atatürk Chest Diseases and Chest Surgery Training and Research Hospital

Status: Completed

Conditions: Postoperative Analgesia; Thoracotomy; Erector Spinae Plane Block; Local Anesthetic

Treatments: Procedure: Same blocks with different local anesthetic volume

Study type: Interventional

Funder types: Other

Identifiers

NCT05083845

E.Kurul-E1-21-1964

Details and patient eligibility

About

It is widely accepted that thoracotomy causes severe acute pain. This increases the frequency of postoperative pulmonary complications and postoperative morbidity. Many analgesic methods have been proposed for thoracotomy pain, including thoracic epidural analgesia (TEA), thoracic paravertebral block (TPVB), intercostal nerve blocks (ICSB), erector spinae plane block (ESPB), serratus anterior plane block (SAPB). Among these methods, ultrasound-guided TPVB and ESPB are the most used methods. TPVB has left its place to newer techniques such as ESPB due to its proximity to the pleura and its deeper location. ESPB is more superficial, easy to access, and less likely to have complications. In addition, ESPB application is increasing in patients who underwent thoracotomy and VATS. There is no consensus on the dose of analgesia in these studies. There are studies on volumes between 10 ml and 40 ml in the literature. In this study, it was aimed to compare the volumes of 20 ml and 30 ml containing local anesthetic at the same concentration (0.25% bupivacaine) of ESPB block to be performed with USG in patients who underwent thoracotomy.

Enrollment: 60 patients

Sex: All

Ages: 18 to 65 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• 18 to 65 years old
• ASA physical status I-II-III
• BMI 18 to 30 kg/m2
• Elective thoracotomy surgery

Exclusion criteria

• Patient refusing the procedure
• Emergency surgery
• History of chronic opioid or analgesic used

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Double Blind

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60 participants in 2 patient groups

Erector Spinae Plane Block with 20 ml %0.25 Bupivacaine

Active Comparator group

Description:

Following the visualization of the anatomical structures, the nerve block needle was advanced via the in-plane technique beneath the erector spinae muscles until the interfascial space was reached. After hydrodissection with 2 ml normal saline, 20 ml 0.25% bupivacaine was injected into the area.

Treatment:

Procedure: Same blocks with different local anesthetic volume

Erector Spinae Plane Block with 30 ml %0.25 Bupivacaine

Active Comparator group

Description:

Following the visualization of the anatomical structures, the nerve block needle was advanced via the in-plane technique beneath the erector spinae muscles until the interfascial space was reached. After hydrodissection with 2 ml normal saline, 30 ml 0.25% bupivacaine was injected into the area.

Treatment:

Procedure: Same blocks with different local anesthetic volume