ESP Block, CNP and QoL After VATS

Hospital Universitario San Ignacio42 enrolled

Overview

The Erector Spinae Plane Block (ESPB) is an adequate alternative for pain management after video-assisted thoracoscopy surgery (VATS). The incidence of postoperative chronic neuropathic pain (CNP) and the quality of life (QoL) in patients with ESPB after VATS remain unknown. We hypothesised that patients with ESPB would have a low incidence of acute and CNP and would report a good QoL up to three months after VATS.

We, therefore, performed this prospective observational study. The a priori primary outcome was incidence of CNP three months postoperatively (POP) in patients undergoing VATS surgery with ESPB as the regional anaesthesia technique. The secondary outcome was to describe pain control at PACU, 12 and 24 hours POP and QoL reported up to three months after surgery. We hypothesised that patients with ESPB would have a low incidence of acute and CNP and report a good QoL.

Study Type

OBSERVATIONAL

Enrollment

Conditions

Postoperative Pain Video-assisted Thoracoscopic Surgery

Interventions

Erector spinae plane blockPROCEDURE

Unilateral ESP block was performed between T3 and T7 levels depending on the thoracic surgical incision. The patient is placed in lateral decubitus position, under sterile conditions, a high frequency (6-15 MHz) linear-array transducer (Sonosite® Edge II, Bothell, USA) was placed in a longitudinal parasagittal orientation 2 cm from the posterior midline to visualise the tips of the transverse processes deep to the erector spinae muscle (ESM). A 21 G, 50 mm or 100 mm needle (Pajunk UniPlex NanoLine; Germany) was advanced in-plane with the ultrasound beam. The needle tip was directed to the plane between the transverse process and the posterior fascia of the ESM. Correct needle tip location was confirmed by ultrasound visualisation of linear fluid spread in the fascial plane. The injection of 0.5 to 1 ml of bupivacaine was 0.5% with epinephrine 5 µg/ml; then, a total of 20-30 ml of the same local anaesthetic was administered.

Eligibility

Sex: ALLMin age: 18 Years

Medical Language ↔ Plain English

Inclusion Criteria: * patients who underwent VATS and required at least one day of hospital stay after surgery Exclusion Criteria: * patients with mental or physical limitation to answer the questionnaires. * patients who required mechanical ventilation. * patients who required surgery conversion to thoracotomy. * patients who declined consent.

Locations (1)

Hospital Universitario

Bogota, Cundinamarca, Colombia

Outcomes

Primary Outcomes

Incidence of chronic neurophatic pain

incidence of CNP three months postoperatively (POP) in patients undergoing VATS surgery with ESPB as the regional anaesthesia technique

Time frame: 3 month

Secondary Outcomes

Postoperative pain

pain control at PACU, 12 and 24 hours POP

Time frame: 24 hours

Quality of Life POP

Quality of Life by EQ-5D

Time frame: 3 months POP

Data from ClinicalTrials.gov

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