The aim of this randomised controlled and double-blind study, is to compare the effects of erector spinae plane (ESP) and thoracic epidural (TEA) blocks on peri-operative hemodynamics and analgesia in patients undergoing unilateral mastectomies due to malignancy.
Patients will be randomised into two groups as Group E (those who received general anesthesia after the erector spina plan block) and Group T (those who received general anesthesia after thoracic epidural block). After the block skin conductivity (galvanic skin response - GSR), body temperature changes, sympathetic and sensory block levels, peri-operative hemodynamic data, postoperative pain scores and analgesic consumption will be recorded.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
TRIPLE
Enrollment
20
After skin infiltration with 2 ml of 2% lidocaine, an 18 G tuohy needle will be directed between the erector spina muscle and the transverse process of the T4 vertebra using the in-plane technique. The location of the needle will be confirmed by hydrodissection with saline after touching the transverse process. After the plan open, 5 ml of 2% lidocaine, 10 ml of 0.5% bupivacaine and 10 ml of saline, including hydrodissection, will be given in a total amount of 25 ml. Then a 20-G epidural catheter will be inserted 3-4 cm and fixed.
After skin infiltration with 2 ml of 2% lidocaine, an 18 G tuohy needle will be entered through the T4-5 interspinous space (median or paramedian approach). After reaching the thoracic epidural area by loss of resistance method, the epidural catheter will be advanced and fixed to remain 3-4 cm in the epidural area. Following the test dose (2 ml of 2% lidocaine), 3 ml of 2% lidocaine, 5 ml of 0.5% bupivacaine and 5 ml of saline will be administered intermittently in a total volume of 15 ml.
Eskisehir Osmangazi University
Eskişehir, Turkey (Türkiye)
Sympathetic block level evaluation with skin conductivity
Skin conductivity will be measured by galvanic skin response (GSR)
Time frame: 45 minutes after block administration
Sympathetic block level evaluation with skin temperature
Skin temperature of bilateral thorax will be measured
Time frame: 45 minutes after block administration
Sympathetic block level evaluation with hot cold test
Hot cold test of bilateral thorax will be measured
Time frame: 45 minutes after block administration
Sympathetic block level evaluation by hemodynamic data
Peri-operative heart rate and mean arterial pressure will be recorded
Time frame: 45 minutes after block administration
Sensorial block level evaluation
By pin-prick test
Time frame: 45 minutes after block administration
intraoperative hemodynamic data
Heart rate and mean arterial pressure
Time frame: During the operation
Postoperative pain scores
Pain score will be measured with visual analog scale (0-no pain; 10-worst pain) during movement and rest.
Time frame: 24 hours after operation
Rescue analgesics consumption
Amount of remifentanil (microgram)
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.
Time frame: During the operation and 24 hours after operation
Rescue analgesics consumption
Amount of tramadol (milligram)
Time frame: 24 hours after operation