ESPB vs TPVB for Postoperative Analgesia After the Nuss Procedure

West China Hospital68 enrolled

Overview

This is a prospective randomized double-blind non-inferiority trial designed to test the hypothesis that erector spinae plane block (ESPB) is non-inferior to thoracic paravertebral block (TPVB) in postoperative pain control after pectus excavatum repair.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

SUPPORTIVE_CARE

Masking

TRIPLE

Enrollment

Conditions

Nerve Block Analgesia Pectus Excavatum

Interventions

ESPB groupPROCEDURE

A 21-gauge 100-mm needle will be inserted into the fascial layer beneath the iliocostalis, longissimus, and spinalis muscles. A bolus of 0.25% ropivacaine 0.5 ml/kg will be injected into the fascial layer. Contralateral ESPB will be performed similarly.

TPVB groupPROCEDURE

A 21-gauge 100-mm insulated needle will be inserted into the paravertebral space via an in-plane parasagittal approach. After perforating the costotransverse ligament, 0.25% ropivacaine 0.5 ml/kg will be injected. Anterior movement of the pleura indicated the appropriate spread of the local anesthetics in the paravertebral space. The process will be repeated on the contralateral side.

Eligibility

Sex: ALLMin age: 4 YearsMax age: 18 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Age between 4 to 18 years Scheduled for elective Nuss surgery Written informed consent is obtained from parents of each patient. Exclusion Criteria: * Coagulation dysfunction. American Society of Anesthesiologists Physical Status 4 or 5. Allergy to study medication. Local infection at the site of injection or systemic infection. Inability to understand Chinese.

Locations (1)

Department of Anesthesiology, West China Hospital

Chengdu, Sichuan, China

Outcomes

Primary Outcomes

Pain scores at rest at 24 hours postoperatively

Pain scores will be recorded using the Numeric Rating Scale (NRS) scores (0-10).

Time frame: 24 hours postoperatively

Secondary Outcomes

The pain degree at rest and after movement or coughing(dynamic)

The pain degree at rest and after movement or coughing at 3, 6, 12, 24, and 48 hours after surgery respectively.

Time frame: at 3, 6, 12, 24, and 48 hours after surgery

total rescue morphine-equivalent consumption per weight

total rescue morphine-equivalent consumption per weight at predetermined time intervals (24 and 48 hours) after surgery

Time frame: at 24 and 48 hours after surgery

Emergence agitation at 5, 15, 30 min after extubation

Emergence agitation will be registered using pediatric anesthesia emergence delirium (PAED) at 5, 15, 30 min after extubation

Time frame: at 5, 15, 30 min after extubation

Total dosage of intraoperative sufentanil and remifentanil

Total dosage of intraoperative sufentanil and remifentanil per weight

Time frame: during surgery

The time to first analgesia request

Time from operation to first rescue analgesia request

Time frame: within the 3 days after surgery

The time to first mobilization

Time from operation to ambulation

Time frame: within the 3 days after surgery

Data from ClinicalTrials.gov

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