Ultrasound-Guided Mid-Point Transverse Process to Pleura Block for Thoracotomy Incisions

Tanta University

Status: Unknown

Conditions: Postoperative Pain; Thoracotomy; Pre-emptive

Treatments: Procedure: Sham group; Procedure: Midpoint transverse process block group

Study type: Interventional

Funder types: Other

Identifiers

NCT05044858

34646/4/21

Details and patient eligibility

About

This study is designed to investigate the analgesic efficacy of pre-emptive ultrasound-guided midpoint transverse process to pleura (MTP) block for posterolateral thoracotomy in cardiothoracic surgeries.

Full description

Preemptive preoperative analgesia was first proposed, over the years it has been gradually regarded as an intervention given before incision, facilitating mobilization and functional rehabilitation after surgery, reducing postoperative opioid consumption, decreasing the incidence of adverse events and improving patient satisfaction.

The Mid Transverse Process to Pleura block, described by Costach et al. involves deposition of drug midway between the transverse process and pleura. Costach et al. postulated that the local anesthetic deposited at this point may reach the paravertebral space through several possible mechanisms, such as spread medially through the gap between the superior costotransverse ligament (SCTL) and vertebral bodies, through fenestrations in SCTL, and laterally through the internal intercostal membrane

Enrollment: 70 estimated patients

Sex: All

Ages: 21 to 65 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Patients aged 21- and65 years old
• American Society of Anesthesiologists (ASA) II-III
• Scheduled for posterolateral thoracotomy operation under general anesthesia

Exclusion criteria

• Patients with bleeding disorders,
• Mental or cognitive dysfunction
• History of chronic analgesic or drug abuse
• Allergy to local anesthetics
• Local infection at site of block

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Double Blind

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70 participants in 2 patient groups

Midpoint transverse process block group

Experimental group

Description:

Patients will receive midpoint transverse process block after induction of general anesthesia and before surgical incision

Treatment:

Procedure: Midpoint transverse process block group

Sham group

Sham Comparator group

Description:

Patients will receive general anesthesia and the same intervention steps will be performed i.e., the block under investigation but instead of local anesthetic a placebo (2ml normal saline) will be injected (sham block)

Treatment:

Procedure: Sham group