The Hemodynamic Effect Between Two Types of Anesthesia in Esophageal Surgery

University Hospital, Lille54 enrolled

Overview

Continuous Paravertebral block (PVB) was reported to provide less episodes of hypotension than continuous thoracic epidural block (TEB). The maintenance of optimal tissue perfusion is essential for esophageal anastomosis in patients undergoing oesophagectomy. the aim of this study is to compare Hemodynamic effect of continous PVB compared to TEB , in patient undergoing oesophagectomy with laparoscopy and thoracotomy.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

SUPPORTIVE_CARE

Masking

SINGLE

Enrollment

Conditions

Epidural Block Oesophageal Cancer Oesophagectomy

Interventions

paravertebral blockOTHER

in the paravertebral block , the catheter was placed under ultrasound echography , at the right thoracic T4/T5 level

thoracic epidural blockOTHER

in the epidural block the catheter was inserted without echography , at T4/T5 level

ropivacaineDRUG

Eligibility

Sex: ALLMin age: 18 YearsHealthy volunteers:

Medical Language ↔ Plain English

Inclusion Criteria: * ASA score 1 to 3 * oesophagectomy : abdominal time with laparoscopy ans thoracic time with thoracotomy Exclusion Criteria: * pregnancy * Uncooperative patient * patient refusal * Coagulopathy * allergy to local anesthetic * Psychological Disorders * Failure to install the epidural or paravertebral catheter. The patient will therefore be excluded secondarily but will be able to benefit from an alternative technique for the management of his pain. * Sepsis * Skin infection at the puncture site * Allergy to local anesthetics * Esophagectomy with cervical surgical time * Patient with chronic pain EVA\> 4 before surgery.

Locations (1)

CHRU , Hôpital Claude Huriez

Lille, France

Outcomes

Primary Outcomes

Frequency of hypotension episodes

The frequency of hypotension episodes defined by a mean arterial pressure (MAP) less than 70mmHg or a decrease in MAP greater than 20% when compared with the preoperative value

Time frame: during perioperative until first 24 hours post operative

Secondary Outcomes

Total amount per patient and per group of vasopressins amines

Time frame: during perioperative until first 24 hours post operative

Frequency of use of vasopressor agents

Time frame: during perioperative until first 24 hours post operative

Volumes of fluid administered

Time frame: during perioperative until the first 24h hours post operative

total amount of morphine consumption

Time frame: during first 48 hours post operative

visual analog scale

Measure the pain severity

Time frame: during first 48 hours post operative, at 3 months and 6 months

DN2 score

evaluation with validated scores for chronic and neuropathic pains

Time frame: during first 48 hours post operative, at 3 months and 6 months

Frequency of surgical complications

Time frame: during first 48 hours post operative

Frequency of pulmonary complications

Time frame: during first 48 hours post operative

Data from ClinicalTrials.gov

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