Assessment of Intercostal Block Scheduling in Preventing Acute Surgical and Post-surgical Pain in Thoracoscopic Surgery
Phase: PHASE4
Conditions: Chest Pain, Surgery
Sponsor: Carmel Medical Center

 
 
 
 
 
 
 
 
 
 
28/06/2016 
Study protocol                                   
 
 
 
 Assessment of intercostal block scheduling in preventing acute surgical and 
post-surgical pain in thoracoscopic surgery  
 
  
 
  
 
  
 
  
 
  
 
 
 
 Entrepreneur   : Dr.   Dan   Levy   Faber 
 
 Address   : Medical cente   Carmel   St. Michel   7, Haifa , 34362  
 
 Site  of the study   : Department   Surgery   chest   House   Patients   Carmel  
 
 Principle Investigator: Dr.   Dan   Levy   Faber  
 
 

Protocol Summary:    
 
Background: Patients undergoing Thoracic surgery may suffer from post-
operative severe pain. Today there is widespread use of the minimally 
invasive approach called VATS = video assisted thoracoscopic surgery. This 
approach reduces postoperative pain, but pain balance is still a Controversial 
issue. In most surgeries performed in our unit, an intercostal block, with 
Bupivacaine, is given during surgery to relieve postoperative pain. This study 
examines whether the timing of block performance at the beginning or end of 
the surgery affects the quality of the patient's pain control balance. 
Methods: This study is a prospective comparative clinical trial between two 
groups of patients. Each group will include 30 randomly assigned patients 
with similar demographic characteristics. Patients were recruited from the 
surgical community in the Department of Chest Surgery at Carmel Medical 
Center according to the inclusion criteria.  
In the study group, an intercostal block will be performed at the beginning of 
the operation and in the control group the intercostal block will be performed 
at the end of the operation.  
The follow-up of Patients will include: assessment of pain levels in the days 
after surgery using visual analogue scale (VAS), calculation of the amount of 
pain medication intake during hospitalization, duration of hospitalization, and 
surgical and postoperative complications. 
 
 Study participants will be above 18 years old and able to sign an informed 
consent.    
 
Inclusion Criteria 
Above 18 years old 
Thoracoscopic Surgery 
No Known allergy to kamacaine 
Able to sign an informed consent 
Non inclusion Criteria 
Previous surgery in the same side of the thorax  
  

 
Inter costal BUPIVACAINE block 
Is an analgesic procedure the involve the injection of BUPIVACAINE between 
the ribs close the intercostal nerve. This procedure blocks the pain 
transmission of the nerves 
 
 BUPIVACAINE   Is an anesthesia medicine from the Amino-amides   Family. 
It is being used for many years  the action   of   the drug   Based   On   tying   
of   The material   To the sodium canals  voltage dependent within the cells 
and blocking the passage of the sodium to the nerves cells. This block   
prevents depolarization   of   The cells. No cell  Depolarization  meaning No 
pain. 
 
 The purpose of   the experiment:  
 
The study try to appreciate the quality of pain control during and after 
thoracoscopic surgery and to see whether change in the timing of the 
intercostal block improve pain control 
 
 
REFERENCE 
. 
 
 
1
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Regional analgesia for video-assisted thoracic surgery: a systematic 
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K. Eur J Cardiothorac Surg.  2013 Nov 27    
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2
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Postoperative analgesia in video-assisted thoracoscopy : the role of 
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 J Cardiothorac   Vasc   Anesth .  2004 Jun ; 18 (3): 317-21    
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3
   
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The efficacy of intraoperative inner intercostal nerve block during 
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 Mt Sinai J Med.  2012 Jan-Feb ; 79 (1): 133-9.  doi : 10.1002 / msj.21286.  
Review    
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6
   
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Paravertebral blocks.Chelly JE.   Anesthesiol   Clin .  2012 Mar ; 30 (1): 
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7
   
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Persistent postoperative pain: where are we now?  Niraj G, 
Rowbotham DJ    
 .
 
 
 Br J Anaesth