US-Guided ESPB Versus TPVB on Acute and Chronic Pain After VATS

Atatürk Chest Diseases and Chest Surgery Training and Research Hospital60 enrolled

Overview

Postoperative acute and chronic pain is frequently observed in patients undergoing video assisted thoracoscopic surgery (VATS). This prolongs the discharge time of patients and increases the frequency of postoperative pulmonary complications. Recently, alternative analgesic methods such as thoracic paravertebral block (TPVB) and erector spinae plane block (ESPB), which are thought to have less side effects than thoracic epidural analgesia, have been used. Among these methods, ultrasound (US) guided TPVB is the most preferred method. In addition, ESPB application is increasing in patients undergoing VATS. In the literature, the number of cases performed with ESPB and randomized controlled prospective studies with ESPB are increasing. In this study, it is planned to compare the effects of US-guided TPVB and ESPB on postoperative acute and chronic pain in patients undergoing VATS.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

DOUBLE

Enrollment

Conditions

Postoperative Pain Video-Assisted Thoracoscopic Surgery Thoracic Paravertebral Block

Interventions

Thoracic paravertebral block vs Erector spinae plane blockPROCEDURE

Thoracic paravertebral block and erector spinae plane block will be performed unilaterally, under US guidance, before the surgical operation, after the induction of anesthesia, when the patient is placed in the lateral decubitus position.

Eligibility

Sex: ALLMin age: 18 YearsMax age: 80 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Age between 18 and 80 years * American Society of Anesthesiologists physical status I-II-III * Body mass index between 18-30 kg/m2 * Patients undergoing elective video assiste thoracoscopic surgery Exclusion Criteria: * Advanced cancer * History of chronic analgesic therapy * History of local anesthetic allergy * Infection in the intervention area * Patients with bleeding disorders

Outcomes

Primary Outcomes

Pain scores

Pain will be assessed at rest and while coughing using the visual analog scale on a scale from 0 (no pain) to 10 (worst pain). Pain assessment will be done at 1st, 2nd, 4th, 8th, 16th and 24th hours after surgery.

Time frame: 24 hours after surgery

Secondary Outcomes

Chronic pain

Chronic pain findings will be evaluated in the 1st month and 3rd month after surgery by using visual analog from 0 (no pain) to 10 (worst pain). Neuropathic pain symptoms (Burning, stabbing, or electric shock-like pain; tingling, numbness, or a "pins and needles" feeling, hyperalgesia, allodynia and hypoesthesia) will also be asked to the participants in the 1st month and 3rd month after surgery.

Time frame: First and 3th month