Ultrasound-guided Block for Thoracic Surgery Pain

Samsung Medical Center

Status: Completed

Conditions: Postoperative Pain; Thoracic Cancer

Treatments: Procedure: serratus anterior plane block; Drug: patient controlled analgesia

Study type: Interventional

Funder types: Other

Identifiers

NCT03240562

SMC2017-06-123

Details and patient eligibility

About

The investigators aimed to assess Ultrasounde- guided serratus anterior plane block can be effective in acute postoperative pain following thoracic surgery.

Full description

Analgesic options for thoracotomy are various with each having their own merits and demerits.Thoracic epidural is said to be the gold standard for management of thoracotomy pain. However, it is invasive procedure and many side effects. Other options include paravertebral block, interpleural block, intrathecal opioids. Especially, paravertebral block is thought good alternative to epidural anethesia. Most of these invasive neuraxial techniques demand normal coagulation parameters to be present.

The serratus anterior plane block(SAPB) was done under ultrasound guidance in the mid-axillary line at the level of the fourth rib and the catheter was placed superficial to the serratus plane. The patient expressed relief in pain within 10 minutes of being given the bolus of local anaesthetic.Pain following thoracotomy is chiefly due to rib retraction, and damage to the serratus/intercostal muscles and intercostal nerves. A SAPB addresses both these aspects. SAPB has been mentioned in previous studies for management of rib fractures and breast surgeries. The investigators try to evaluate whether the SAPB is easy to perform and provides effective analgesia in patients undergoing thoracotomy with minimal side effects.

Enrollment: 89 patients

Sex: All

Ages: 20 to 80 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

•undergoing thoracic surgery (lobectomy or segmentectomy)

Exclusion criteria

• allergy to any drugs chronic pain disease with medication psychologic disorder anti-depressant drug chronic kidney disease ( Cr over 2.0 mg/dl) coagulopathy

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Double Blind

---

89 participants in 2 patient groups

IV-PCA group

Sham Comparator group

Description:

no block performing, only use intravenous patient controled analgesia(IV-PCA)

Treatment:

Drug: patient controlled analgesia

SAPB group

Experimental group

Description:

serratus anterior plane block(SAPB) and intravenous patient controled analgesia(IV-PCA)

Treatment:

Drug: patient controlled analgesia

Procedure: serratus anterior plane block