Thoracic Paravertebral Block, Erector Spinae Plane Block, and in Combined Paravertebral-erector Spinae Block

Atatürk Chest Diseases and Chest Surgery Training and Research Hospital

Status: Completed

Conditions: Thoracic Surgery, Video-Assisted; Erector Spinae Plane Block; Thoracic Paravertebral Block; Pain, Postoperative

Treatments: Procedure: Two different block and combination of these two blocks

Study type: Interventional

Funder types: Other

Identifiers

NCT04929665

E.Kurul-E1-21-1688

Details and patient eligibility

About

Video-assisted thoracic surgery (VATS) has become a common procedure in thoracic surgery. Severe postoperative pain may be encountered in patients undergoing VATS. Analgesic methods such as thoracic paravertebral block (TPVB), intercostal block and erector spina plane block (ESPB) are widely used for VATS. Among these methods, ultrasound (US) guided TPVB is the most preferred method. Generally, comparisons are made between ESPB and TPVB in studies and the analgesic effect is evaluated. However, no research could be found in the literature combining ESPB and TPVB. The mechanisms of regional analgesia techniques used after thoracic surgery operations are also different from each other. Therefore, it may be possible to obtain a more effective analgesic effect in patients by combining the mechanism of action of TPVB and ESPB, as in the multimodal analgesia method. This study seeks to evaluate the effect of TPVB, ESPB and combined TPVB-ESPB pain after VATS.

Enrollment: 75 patients

Sex: All

Ages: 18 to 80 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• 18 to 80 years old
• ASA physical status I-II-III
• BMI 18 to 30 kg/m2
• Elective video assisted thoracoscopic surgery

Exclusion criteria

• Patient refusing the procedure
• Emergency surgery
• Chronic opioid or analgesic use

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Quadruple Blind

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75 participants in 3 patient groups

Thoracic Paravertebral Block

Active Comparator group

Description:

In patients who are planned to have a thoracic paravertebral block, the needle will be advanced to the paravertebral area with ultrasound-guided in-plane technique. 20 ml of 0.25% bupivacaine will be injected into this area.

Treatment:

Procedure: Two different block and combination of these two blocks

Erector spinae block

Active Comparator group

Description:

Patients who are planned to have an erector spina block will be advanced to the interfacial area under the erector spinae muscle by ultrasound-guided in-plane technique. 20 ml of 0.25% bupivacaine will be injected into this area.

Treatment:

Procedure: Two different block and combination of these two blocks

Thoracic Paravertebral block and Erector spinae Block

Active Comparator group

Description:

In patients who are planned to have combined erector spinae block and thoracic paravertebral block, the needle will be advanced to the paravertebral area with ultrasound-guided in-plane technique. 10 ml of 0.25% bupivacaine will be given to this area. Then, with the same needle, return 1-2 cm from the paravertebral area and inject 10 ml of 0.25% bupivacaine into the interfacial area under the erector spinae muscle.

Treatment:

Procedure: Two different block and combination of these two blocks