Ultrasound-guided Approach Combined With Pressure Measurement Technique to Thoracic Paravertebral Block

Yeungnam University College of Medicine

Status: Unknown

Conditions: Thoracotomy

Treatments: Procedure: thoracic paravertebral block using pressure measurement technique

Study type: Interventional

Funder types: Other

Identifiers

NCT03868917

apsj07180304

Details and patient eligibility

About

Posterolateral thoracotomies are among the most painful procedures of surgery and may cause severe postoperative chest pain and impaired respiratory performance. Paravertebral block (PVB) is an established method of administering postoperative analgesia for thoracic procedures. PVB blocks the somatic and sympathetic nervous systems and is placed by injecting a local anesthetic (LA) into the paravertebral space where the nerve and its branches are located after exiting the intervertebral foramen. But previous study showed 5-10% of failure rate in PVB using ultrasound machine. Pressure measurement during needle advancement could improve reliability of correct needle placement. When the needle tip reaches paravertebral space, there is a sudden lowering of pressures due to respiratory cycle. Therefore, sensitivity and specificity could be improved and correct needle placement become objective and reproducible when PVB using ultrasound is combined with pressure measurement during needle advancement.

Enrollment: 72 estimated patients

Sex: All

Ages: 19 to 85 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Scheduled for elective thoracotomy
• ASA status 1,2

Exclusion criteria

• Inability to provide adequate informed consent
• Any contraindication to the placement of thoracic paravertebral catheters
• Unstable vertebral and transverse process fractures
• Any chronic painful conditions or preoperative opioid use Any chronic painful conditions or preoperative opioid use
• Coagulation abnormalities or expectation to be on therapeutic anticoagulants postoperatively
• Allergy to any of the drugs/agents used in study protocol
• Altered mental status or emergency surgery
• Comorbid conditions such as sepsis, unstable angina, congestive heart failure

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Double Blind

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72 participants in 2 patient groups

ultrasound group

No Intervention group

Description:

The participants have continuous thoracic paravertebral block performed using only the ultrasound approach.

pressure measurement group

Experimental group

Description:

The participants have continuous thoracic paravertebral block performed using the ultrasound-guided approach combined with pressure measurement techniqueduring needle advancement.

Treatment:

Procedure: thoracic paravertebral block using pressure measurement technique