Ignite Creation Date:
2024-05-06 @ 6:50 PM
Last Modification Date:
2024-10-26 @ 2:55 PM
Study NCT ID:
NCT05791539
Status:
RECRUITING
Last Update Posted:
2023-08-30
First Post:
2022-12-16
Brief Title:
Comparison Between Retrolaminar Block Combined With Erector Spinae Plane Block and Erector Spinae Plane Block Alone for Post-thoracotomy Pain
Sponsor:
Cairo University
Organization:
Cairo University
Study Overview
Official Title:
Comparison Between Retrolaminar Block Combined With Erector Spinae Plane Block and Erector Spinae Plane Block Alone for Post-thoracotomy Pain
Status:
RECRUITING
Status Verified Date:
2023-08
Last Known Status:
None
Delayed Posting:
No
If Stopped, Why?:
Not Stopped
Has Expanded Access:
False
If Expanded Access, NCT#:
N/A
Has Expanded Access, NCT# Status:
N/A
Acronym:
None
Brief Summary:
Post-thoracotomy pain is a challenging clinical problem that may be associated with increased morbidity and mortality The current study tests two techniques of regional anaesthesia to control post thoracotomy pain
Detailed Description:
Post-thoracotomy pain is a challenging clinical problem that may be associated with increased morbidity and mortality
The surgical incision produces post-thoracotomy pain PTP via damage to the ribs and intercostal nerves inflammation of the chest wall pleura or pulmonary parenchyma cutting and placement of the intercostal chest tube Acute PTP inhibits the ability to breathe and cough normally Numerous analgesic techniques are used to relieve PTP including systemic opioids regional techniques such as paravertebral nerve blockade intercostal nerve blockade intrapleural analgesia and epidural opioids with or without local analgesia cryo-analgesia and transcutaneous electrical nerve stimulation TENS
Emerging research has shown that the novel erector spinae plane block ESPB can be employed as a simple and safe alternative analgesic technique for acute post-surgical post-traumatic and chronic neuropathic thoracic pain in adults
ESPB was first reported in 2016 for ipsilateral thoracic analgesia It was found to be a safe and effective block that can be performed by an emergency physician in the emergency department setting for addressing acute pain due to multiple rib fractures
Retrolaminar block RLB was first reported in 2006 as an alternative approach to PVB RLB is performed with US imaging or the landmark technique The efficacy of continuous RLB has been reported for breast cancer surgery
However the efficacy of ESPB has been described in a greater number of clinical reports than has RLB a rib fracture breast surgery thoracoscopic surgery lumbar spinal surgery and laparoscopic abdominal surgery In contrast to RLB most of the literature on ESPB reported the use of the single-shot technique 802 The local anesthetic was postulated to infiltrate the ventral and dorsal rami of the spinal nerve However Ueshima et al reported that ESPB could not provide adequate analgesia of the anterior branch of the intercostal nerve
The rationale of the study is that to the best of our knowledge each of ESPB and RLB has limitations regarding sensory block and distribution so our hypothesis is combining both will provide more solid block regarding sensory distribution time interval of the block efficacy and postoperative morphine consumption in patients undergoing thoracic surgeries
Few studies evaluated the efficacy of ultrasound US guided erector spinae plane block on post-thoracotomy analgesia however for the best of our knowledge no one compared the effect of ultrasound US guided retrolaminar block combined with erector spinae plane block and ultrasound US guided erector spinae plane block alone in patients undergoing thoracic surgeries
The surgical incision produces post-thoracotomy pain PTP via damage to the ribs and intercostal nerves inflammation of the chest wall pleura or pulmonary parenchyma cutting and placement of the intercostal chest tube Acute PTP inhibits the ability to breathe and cough normally Numerous analgesic techniques are used to relieve PTP including systemic opioids regional techniques such as paravertebral nerve blockade intercostal nerve blockade intrapleural analgesia and epidural opioids with or without local analgesia cryo-analgesia and transcutaneous electrical nerve stimulation TENS
Emerging research has shown that the novel erector spinae plane block ESPB can be employed as a simple and safe alternative analgesic technique for acute post-surgical post-traumatic and chronic neuropathic thoracic pain in adults
ESPB was first reported in 2016 for ipsilateral thoracic analgesia It was found to be a safe and effective block that can be performed by an emergency physician in the emergency department setting for addressing acute pain due to multiple rib fractures
Retrolaminar block RLB was first reported in 2006 as an alternative approach to PVB RLB is performed with US imaging or the landmark technique The efficacy of continuous RLB has been reported for breast cancer surgery
However the efficacy of ESPB has been described in a greater number of clinical reports than has RLB a rib fracture breast surgery thoracoscopic surgery lumbar spinal surgery and laparoscopic abdominal surgery In contrast to RLB most of the literature on ESPB reported the use of the single-shot technique 802 The local anesthetic was postulated to infiltrate the ventral and dorsal rami of the spinal nerve However Ueshima et al reported that ESPB could not provide adequate analgesia of the anterior branch of the intercostal nerve
The rationale of the study is that to the best of our knowledge each of ESPB and RLB has limitations regarding sensory block and distribution so our hypothesis is combining both will provide more solid block regarding sensory distribution time interval of the block efficacy and postoperative morphine consumption in patients undergoing thoracic surgeries
Few studies evaluated the efficacy of ultrasound US guided erector spinae plane block on post-thoracotomy analgesia however for the best of our knowledge no one compared the effect of ultrasound US guided retrolaminar block combined with erector spinae plane block and ultrasound US guided erector spinae plane block alone in patients undergoing thoracic surgeries
Study Oversight
Has Oversight DMC:
None
Is a FDA Regulated Drug?:
False
Is a FDA Regulated Device?:
False
Is an Unapproved Device?:
None
Is a PPSD?:
None
Is a US Export?:
None
Is an FDA AA801 Violation?:
None