Transversus Thoracic Muscle Plane Block, Erector Spinae Plane Block and Paravertebral Block for Analgesia in Video-Assisted Thoracic Surgery

Tanta University

Status: Completed

Conditions: Erector Spinae Plane Block; Transversus Thoracic Muscle Plane Block; Video-Assisted Thoracic Surgery; Analgesia; Paravertebral Block

Treatments: Other: Transversus thoracic muscle plane block; Other: Thoracic paravertebral block; Other: Erector spinae plane block

Study type: Interventional

Funder types: Other

Identifiers

NCT06987136

36264PR1184/4/25.

Details and patient eligibility

About

The aim of this study is to compare the transversus thoracic muscle plane block (TTPB), erector spinae plane block (ESPB), and thoracic paravertebral block (TPVB) for postoperative analgesia in patients undergoing video-assisted thoracoscopic surgery (VATS).

Full description

Traditionally, resection is done via a thoracotomy. Still, video-assisted thoracoscopic surgery (VATS) provides significant advantages over open thoracotomy procedures, including reduced surgical pain, improved postoperative pulmonary function, reduced mortality, shortened hospital stay. It has emerged as a minimally invasive alternative.

Thoracic paravertebral block (TPVB) is a regional anesthetic technique in which local anesthetic (LA) is administered inside the thoracic paravertebral space (TPVS), which contains the intercostal spinal nerves, spinal dorsal rami, rami communicants, sympathetic chain, intercostal vessels, and fatty tissue.

The erector spinae plane block (ESPB) is an interfascial regional anesthesia block for thoracic analgesia which can be performed by superficial or deep needle approach.

Transversus thoracic muscle plane block (TTPB) is a newly developed technique in which LA is injected into the fascial plane between the transversus thoracic muscle and the internal intercostal muscles for blocking the anterior cutaneous branches of intercostal nerves from thoracic (Th) 2 to Th 6.

Enrollment: 60 patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Age ≥ 18 years.
• Both sexes.
• American Society of Anesthesiology (ASA) physical status I-II.
• Scheduled for video-assisted thoracic surgery under general anesthesia.

Exclusion criteria

• Body mass index >30 kg/m2.
• Coagulopathy.
• History of opiate abuse.
• Pre-existing chronic pain.
• Allergy to local anesthetics or analgesics.
• Infection at the site of injection.
• Mental or neurological disorders.
• Operation converted to open thoracotomy.
• Renal dysfunction (glomerular filtration rate (GFR) < 50 ml/min).
• Pregnancy

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Double Blind

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60 participants in 3 patient groups

Transversus thoracic muscle plane block group

Experimental group

Description:

Patients will receive a transversus thoracic muscle plane block.

Treatment:

Other: Transversus thoracic muscle plane block

Erector spinae plane block group

Experimental group

Description:

Patients will receive an erector spinae plane block.

Treatment:

Other: Erector spinae plane block

Thoracic paravertebral block group

Experimental group

Description:

Patients will receive a thoracic paravertebral block.

Treatment:

Other: Thoracic paravertebral block