The Impact of Video-assisted Thoracic Surgery and Regional Anaesthesia on Postoperative Opioid Consumption and Pain Scores

Antalya Training and Research Hospital96 enrolled

Overview

This present study aims is to compare the effects of ultrasound-guided paravertebral block, intertransverse process block, and erector spinae plane block on postoperative opioid consumption, and pain scores in patients undergoing VATS.

Video-assisted thoracic surgery (VATS) has become increasingly popular in Thoracic Surgery due to faster recovery and less postoperative pain compared to thoracotomy. However, although VATS has been reported to cause less postoperative pain than thoracotomy, it has also been shown to significantly increase the risk of acute and chronic postoperative pain, which negatively impacts postoperative pain recovery. Inadequate postoperative pain management can reduce the quality of a patient's recovery and increase the risk of postoperative pulmonary complication. Therefore, controlling pain in patients undergoing VATS is key to ensuring early mobilisation, and minimising the risk of pulmonary complications. Regional anaesthesia techniques are an important part of multimodal analgesia approach in patients undergoing VATS. The aim of the present study is to compare the effects of ultrasound-guided regional anaesthesia techniques on postoperative opioid consumption, and pain scores in patients undergoing VATS.

Study Type

OBSERVATIONAL

Enrollment

Conditions

Thoracic Surgery Videoassisted Thoracoscopic Surgery,One-lung Ventilation Regional Anaesthesia Postoperative Analgesia

Interventions

Paravertebral block groupOTHER

Before the surgery, ultrasoud-guided paravertebral block will be performed before the surgery under standart anaesthesia monitoring

İntertransverse process block groupOTHER

Before the surgery, ultrasoud-guided intertransverse process block will be performed before the surgery under standart anaesthesia monitoring

Erector spinae plane block groupOTHER

Before the surgery, ultrasoud-guided erector spinae plane block will be performed before the surgery under standart anaesthesia monitoring

Eligibility

Sex: ALLMin age: 18 YearsMax age: 75 Years

Medical Language ↔ Plain English

Inclusion Criteria: * aged 18-75 years * American Society of Anaesthesiology (ASA) score I-III * body mass index (BMI) \<35kg/m2 * scheduled for elective VATS Exclusion Criteria: * ASA score ≥4 * BMI ≥35 kg/m2 * declining to give written informed consent * controendications for block application * inability to undergo block application * history neurological disease or peripheral nerve disease * history of chronic opioid use * history of severe liver or kidney failure * patients admitted to the intensive care unit postoperatively intubated

Outcomes

Primary Outcomes

Postoperative opioid consumption

All patients will receive a standard patient analgesia (PCA) protocol after operation. The postoperative opioid consumption will only be recorded.

Time frame: 24 hours

Secondary Outcomes

Postoperative Numerical Rating Scale (NRS) pain scores

The postoperative pain intensity will be assessed with the Numerical Rating Scale (NRS) score (0=no pain; 10=most severe pain).

Time frame: postoperative 24 hours

Chronic pain

Patients will be telephoned 3 months after the surgery and the presence, localization, intensity of the pain , its character, and its relation with rest and/or activity will be recorded by asking only verbally.

Time frame: 3 months