Thoracotomy Closure Technique and Postoperative Pain Study: A Randomized Controlled Trial

University of Michigan

Status: Completed

Conditions: Hernia; Lung Cancer

Treatments: Procedure: Pericostal suture technique; Procedure: Intracostal suture technique

Study type: Interventional

Funder types: Other

Identifiers

NCT02063438

HUM00082406

Details and patient eligibility

About

The purpose of this study is to examine pain associated with thoracotomy (incision made during surgery to obtain access to your thoracic cavity) and how the closure technique may influence postoperative pain. Two types of routinely selected thoracotomy closure techniques will be examined; pericostal and intracostal sutures. The investigators hypothesize that intracostal sutures will result in less postoperative and chronic pain as a result of less compression of the intercostal nerve.

Enrollment: 255 patients

Sex: All

Ages: 18 to 99 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Patients undergoing an elective procedure that will include a thoracotomy.
• All patients will undergo epidural catheter placement.

Exclusion criteria

• Previous thoracotomy on the operative side.
• Previous history of chronic chest pain.
• Previous history of thoracic trauma on the operative side.
• Less than 18 years of age
• Inability to provide informed consent or to complete testing or data collection
• Need for a chest wall resection
• Patients requiring other incisions in addition to a thoracotomy (i.e., Laparotomy, sternotomy

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Single Group Assignment

Masking: Double Blind

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255 participants in 2 patient groups

Pericostal Suture Technique

Active Comparator group

Description:

A #2 Vicryl suture is placed along the superior aspect of the rib above the specific thoracic interspace. This suture is then passed below the inferior rib along the superior aspect of the next rib below. These sutures are then tied to approximate the ribs leaving enough room for the tip of a finger.

Treatment:

Procedure: Pericostal suture technique

Intracostal Suture Technique

Active Comparator group

Description:

A handheld drill is used to drill holes in the rib below the specific thoracic interspace. A #2 Vicryl suture is passed through each of the holes and then passed along the superior aspect of the rib above the specific thoracic interspace. These sutures are then tied to approximate the ribs leaving enough room for the tip of a finger.

Treatment:

Procedure: Intracostal suture technique