Investigators will analyze the efficacy of continuous regional anesthesia through a catheter under erector spinae muscle in a prospective, randomized, double blind, placebo-controlled study. Investigators will include 50 adults, predicted for elective lung surgery with video-assisted thoracic surgery (VATS) technique. Patients will be randomly assigned to group A or B. Investigators will insert a catheter under the erector spinae muscle (ESC) at the T4 level of the operated side under ultrasound guidance. All patients will receive an initial bolus of 20ml levobupivacaine 0,5% through the catheter. Group A will receive a continuous infusion 5ml/h of ropivacaine 0,2% and intermittent boluses of the same local anesthetic 15ml/4h through the ESC. Group B will receive a continuous infusion of 0,9% saline in the same doses. All patients will have a PCA pump with piritramide 1mg/ml to cover the pain. All patients will receive regular doses of paracetamol and metamizole as part of multimodal analgesia. Investigators will compare pain, assessed with the VAS scale in resting and coughing and piritramide usage in both groups. Investigators will compare the incentive spirometry results at 24 and 48 hours postoperatively and observe for possible late complications.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
TRIPLE
Enrollment
50
Group A will receive the medicine through the erector spinae catheter.
Group B will receive Saline 0,9% through the erector spinae catheter.
Surgery Bitenc
Golnik, Slovenia
RECRUITINGUsage of opioid analgetics
Investigators will measure the total consumption of i.v. piritramide after surgery.
Time frame: Continually 48 hours post surgery
Subjective pain score
Investigators will measure subjective perception of pain with the visual analogue scale (VAS) scoring system at resting and coughing. The VAS scoring system is a numerical scale from 0-10, with 0 being no pain and 10 the strongest pain imaginable. Patients will assess their pain with the help of analogue scale with colours and faces by each number representing different VAS pain levels.
Time frame: Every hour in the 48 hours post surgery
Incentive spirometry
Investigators will assess spirometry with a manual device.
Time frame: 24 and 48 hours after surgery
Satisfaction with analgesia
Investigators will assess satisfaction with qualitative and quantitative questionnaries.
Time frame: 1 day (at dismissal from hospital.)
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