This study aims to compare the costotransverse foramen block (CTFB) with thoracic paravertebral block (TPVB) in patients undergoing thoracotomy for lung cancer.
Thoracotomy is known to be one of the most painful surgeries. Managing post-thoracotomy pain is a major clinical challenge, as about 75% of patients report moderate to severe pain afterward. Various regional and central analgesia techniques, such as thoracic epidural analgesia (TEA), thoracic paravertebral block (TPVB), and erector spinae plane block (ESPB), are employed in a multimodal approach. Although TEA has traditionally been considered the gold standard for thoracotomy pain control, concerns about its side effects have prompted the exploration of alternatives. The costotransverse foramen block (CTFB), a recently introduced technique, has been examined in both cadaveric and case studies.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
DOUBLE
Enrollment
70
Patients will receive an ipsilateral ultrasound-guided costotransverse foramen block with injection of 20 ml bupivacaine 0.25%.
Patients will receive an ipsilateral ultrasound-guided thoracic paravertebral plane block with injection of 20 ml bupivacaine 0.25%.
Cairo University
Cairo, Egypt
RECRUITINGTotal morphine consumption
If the visual analog scale (VAS) is ≥ 4, rescue analgesics will be administered in the form of a 4 mg bolus of morphine.
Time frame: 24 hours postoperatively
Duration of analgesia
Duration of analgesia will be recorded from the end of surgery till first dose of morphine administrated.
Time frame: 24 hours postoperatively
Degree of pain
Each patient will be instructed about postoperative pain assessment with the visual analog scale (VAS). VAS (0 represents "no pain" while 10 represents "the worst pain imaginable"). VAS will be recorded in post-anesthesia care unit (PACU) and after 1, 6, 12, 24 \& 48 hours postoperatively
Time frame: 48 hours postoperatively
Intraoperative fentanyl consumption
Intraoperative fentanyl consumption will be recorded.
Time frame: Intraoperatively
Mean arterial blood pressure
Mean arterial blood pressure will be recorded before induction of general anesthesia to be defined as the baseline reading. Another reading will be noted immediately before surgical incision and at 20-minute intervals intraoperatively, and then hourly for the next 4 hours postoperatively.
Time frame: 4 hours postoperatively
Heart rate
Heart rate will be recorded before induction of general anesthesia to be defined as the baseline reading. Another reading will be noted immediately before surgical incision and at 20-minute intervals intraoperatively, and then hourly for the next 4 hours postoperatively.
Time frame: 4 hours postoperatively
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Incidence of block-related side effects
Incidence of block-related side effects such as unexpected epidural anesthesia, pneumothorax, total spinal anesthesia, or local anesthetic intoxication will be recorded.
Time frame: 4 hours postoperatively
Incidence of side effects
Incidence of side effects such as postoperative nausea and vomiting, drowsiness, or dyspnea will be recorded.
Time frame: 4 hours postoperatively