The objective is to investigate the safety and effectiveness of rhomboid intercostal and subserratum plane (RISS) block for postoperative analgesia after minimally invasive McKeown esophagectomy (MIE-McKeown).
Rhomboid intercostal and subserratum plane block (RISS) is a nerve block technique in which local anesthetics are injected into the rhomboid-intercostal muscle planes and the serratus anterius-intercostal muscle planes, and the intercostal nerve is blocked by diffusion of local anesthetics. It is confirmed that RISS can provide analgesia not only in the front half of the chest, but also in the upper abdomen. However, the efficacy of RISS in minimally invasive surgery for esophageal cancer has not been proven. The investigators placed catheters on the RISS plane and continuously injected local anesthetics to investigate whether RISS is effective and safe in minimally invasive esophageal cancer surgery.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
96
Before the operation,the patient was placed in the left lateral position.The catheter（soft tip epidural catheter 20-gauge-100 cm） was placed at the rhomboid-intercostal plane under ultrasound guidance at the T5-T6 level, followed by ultrasound-guided catheter placed in the anterior serrated muscle plane at the T7-9 level。
Before the operation,40milliliters of 0.3% ropivacaine was injected into the rhomboid-intercostal fascia plane and anterior serrated muscle plane respectively under the guidance of ultrasound.
After surgery,local anesthetics were injected continuously through catheters.Local anesthetic formula:Ropivacaine 300mg + normal saline, prepared into 150milliliters liquid, background dose 2milliliters/h.
FulingCH
Chongqing, China
RECRUITINGAnalgesic effect
patient will be asked to rate their pain level at rest and cough respectively using visual analogue scale（VAS）.(0 being no pain, 10 being worst pain imaginable)
Time frame: 2, 6, 12, 24, and 48 hours after surgery
mean arterial pressure (MAP)
The mean arterial pressure (MAP)on the monitor at different times was recorded.
Time frame: before anesthesia induction (T0)， before skin incision（T1）， 5 minutes after skin incision
Heart rate (HR)
The Heart rate (HR)on the monitor at different times was recorded.
Time frame: before anesthesia induction (T0)， before skin incision（T1）， 5 minutes after skin incision
dizziness
The occurrence of dizziness was recorded
Time frame: 24hours after surgery
lethargy
The occurrence of lethargy was recorded
Time frame: 24hours after surgery
nausea or vomiting
The occurrence of nausea /vomiting was recorded
Time frame: 24hours after surgery
hypotension
The occurrence of hypotension was recorded
Time frame: 24hours after surgery
respiratory depression
The occurrence of respiratory depression was recorded
Time frame: 24hours after surgery
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After surgery, the patient was given controlled intravenous analgesia. Analgesic pump drug formula:Sufentanil 50ug+ Dezocine 20mg+ Granisetron 10mg+150milliliters saline, continuous dose of 2milliliters/h intravenous pump, single injection dose of 2milliliters, locking time of 20 min
urinary retention
The occurrence of urinary retention was recorded
Time frame: 24hours after surgery
Analgesia satisfaction
patient will be asked to rate their Satisfaction with analgesia using verbal rating scales (VRS) .Scores from 1 to 5 represent very dissatisfied, not satisfied, basically satisfied, relatively satisfied, and very satisfied with the analgesic effect, respectively.
Time frame: 24hours after surgery