The aim of the study is to determine which regional anaesthesiological technique (thoracic epidural analgesia or paravertebral block) is more suitable for thoracic surgery
Thoracic interventions (lung operations) are associated with considerable postoperative pain, whereby an open surgical procedure via a skin incision (thoracotomy) is more painful than a minimally invasive endoscopic intervention (thoracoscopy). In order to reduce pain, a regional anaesthetic is administered during the induction of anaesthesia, which reduces pain both intraoperatively and postoperatively. In thoracic surgery, thoracic epidural analgesia (PDA) and paravertebral block (PVB) are the main regional anaesthesiological measures used, although it is unclear which of the two procedures is superior in terms of efficiency and effectiveness. Particularly intraoperatively, but also to some extent postoperatively, regional anaesthesia alone is usually not sufficient for pain management. Rather, additional systemic (i.e. intravenous) analgesics (especially opioids) are administered. Therefore, the amount of these additionally administered analgesics is a measure of the efficiency of the regional anaesthesia procedure.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
DOUBLE
Enrollment
118
Patients receive either a thoracic epidural analgesia or paravertebral block as an regional anaesthetic adjunct to general anaesthesia for thoracic surgery
Dept. of Anaesthesiology and Intensive Care Medicine, University of Bonn
Bonn, Germany
RECRUITINGHelios Klinikum Bonn/Rhein-Sieg
Bonn, Germany
RECRUITINGOpiate consumption
intraoperative opiate consumption
Time frame: intraoperative
pain score
Numeric Rating Scale (NRS), ranging from 0 (no pain) to 10 (worst imaginable pain). A higher NRS score indicates a worse outcome.
Time frame: from admission to post-anaesthesia care unit (PACU) until discharge from PACU (up to 1 hour after admission)
postoperative pain
cumulative dose of postoperatively given pain medication
Time frame: up to day 2 after surgery
anaesthetic depth
Bispectral Index
Time frame: intraoperative
intraoperative nociception
Nociception Level (NOL)
Time frame: intraoperative
Patient recovery
Quality of Recovery Score (QoR-15) ranging from 0-150, with a higher value representing a better outcome
Time frame: at day 1 after surgery
Patient satisfaction
Bauer Satisfaction Questionnaire, consisting of 10 questions on anaesthesia-related discomfort (with 3 answer options: No/ Yes, moderate/ Yes, severe) and 5 questions on satisfaction with anaesthesia care (with 4 answer options: very satisfied/ satisfied / dissatisfied/ very dissatisfied)
Time frame: at day 2 after surgery
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