External Oblique Intercostal Plane Block Versus Thoracic Paravertebral Block for Post Thoracotomy Pain

Tanta University90 enrolled

Overview

The aim of this study is to compare the effectiveness of analgesia achieved by external oblique intercostal plane block (EOIPB)and thoracic paravertebral block (TPVB) for postoperative pain management in patients undergoing open thoracotomy.

Acute thoracotomy pain is multifactorial in nature. It involves nociceptive and neuropathic mechanisms originating from somatic and visceral afferents. The main sources of pain are intercostal nerves, the vagus nerve and phrenic nerve in the pleura, the superficial cervical plexus, and the brachial plexus in the ipsilateral shoulder.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

PREVENTION

Masking

DOUBLE

Enrollment

Conditions

External Oblique Intercostal Plane Block Thoracic Paravertebral Block Post Thoracotomy Pain

Interventions

External oblique intercostal plane blockOTHER

Patients will receive external oblique intercostal plane block

Thoracic paravertebral blockOTHER

Patients will receive thoracic paravertebral block

Eligibility

Sex: ALLMin age: 18 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Age ≥ 18 years. * Both sexes. * American Society of Anesthesiology (ASA) physical status I-III. * Scheduled for open thoracotomy Exclusion Criteria: * Patients with neurological or intellectual disability. * Infection at the injection site. * Opioid addiction. * Allergic reaction to local anesthetics. * Coagulation abnormalities. * Drug abuse. * Pregnancy. * Severe liver and/or renal failure. * Uncontrolled hypertension. * Severe cardiovascular problems. * Diabetes mellitus.

Locations (1)

Tanta University Hospitals

Tanta, El-Gharbia Governorate, Egypt, Egypt

Outcomes

Primary Outcomes

Total morphine consumption

Rescue analgesia of morphine will be given as 2 mg bolus if the numeric rating scale (NRS) \> 3 to be repeated after 30 min if pain persists until the numeric rating scale \< 4. numeric rating scale will be assessed at 0, 4, 8, 12, 18 and 24h postoperatively.

Time frame: 24 hours postoperatively

Secondary Outcomes

Intraoperative fentanyl consumption

Additional fentanyl bolus dosages of 1 µg/kg IV will be administered if heart rate or mean arterial blood pressure elevated more than 20% of the baseline (after exclusion of other causes than pain).

Time frame: Intraoperative

Mean arterial pressure

Mean arterial pressure will be recorded preoperative, before performing of block, and every 15 min till the end of surgery.

Time frame: Till the end of surgery

Heart rate

Heart rate will be recorded preoperative, before performing of block, and every 15 min till the end of surgery.

Time frame: Till the end of surgery

Time to the 1st rescue analgesia

All patients will receive paracetamol 1 gm every 6 h as routine analgesia. Rescue analgesia of morphine will be given as 2 mg bolus if the numeric rating scale \> 3 to be repeated after 30 min if pain persists until the numeric rating scale \< 4. NRS will be assessed at 0, 4, 8, 12, 18 and 24h postoperatively

Time frame: 24 hours postoperatively

Degree of pain

Degree of pain will be measured using numeric rating scale (NRS) (0 represents "no pain" while 10 represents "the worst pain imaginable").NRS will be assessed at 0, 4, 8, 12, 18 and 24h postoperatively.

Data from ClinicalTrials.gov

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