ESP vs ESP With PECS
Condition: Postoperative Pain; Mitral Valve Disease
MeSH terms: Pain, Postoperative
Study type: Interventional
Phase: Phase 4

Summary: 
      Patients scheduled for minimally invasive mitral valve repair. Each patient will be treated
      with intravenous (i.v.) oxycodone - patient-controlled analgesia (PCA). Patients will be
      allocated to one of the groups: erector spinae plane (ESP) block or EPS with pectoral fascia
      (PECS) block.
    

Detailed description: 
      Only patients who are qualified for an elective procedure of mitral valve replacement may
      participate in the study. Each patient will be anesthetized generally. The same drugs will be
      used in each stage of anesthesia. The induction: etomidate, remifentanil, rocuronium, scolina
      as required. The maintenance: sevoflurane, remifentanil, rocuronium. The emergence: oxygen,
      sugammadex or neostigmine a required.

      Patients will be randomly allocated to one of two groups: ESP or PECS. Among the patients
      from ESP group will have ESP blockade before the induction of general anesthesia. ESP
      blockade will be performed under ultrasound control. A single-shot technique will be used
      with 0.375 % solution of ropivacaine: 0.1 mL per patient KG. The maximum dose is 20 mL.

      Patients from PECS group will receive ESP block and PECS I and II type block with 0.375 %
      solution of ropivacaine (up to 20 mL of local anesthetic).

      Each patient, before the end of surgery, will be administered i.v. 0.1 mg of oxycodone. PCA
      with oxycodone (1mg/mL) will be utilized during the postoperative period: 7-minute interval.
      This is standard protocol in the investigator's department.

      Only patients who are successfully awakened after the procedure may participate in the study.

      The pain intensity will be assessed with visual-analogue scale (VAS) at 2, 4, 8, 12 and 24
      hour after the end of anesthesia.

      The total consumption of oxycodone will be also monitored.
    

Intervention name(s): Erector Spinae Plane blockade; Pectoral Fascia block; Oxycodone; general anesthesia; paracetamol
Intervention type(s): Procedure; Procedure; Drug; Procedure; Drug
Intervention description(s): Before the beginning of the procedure, ESP blockade will be performed under ultrasound control. A single-shot technique will be used with 0.375 % solution of ropivacaine: 0.1 mL per patients' KG. The maximum dose is 20 mL.; Before the beginning of the procedure, PECS type I and II blocks will be performed under ultrasound control. A single-shot technique will be used with 0.375 % solution of ropivacaine: 0.1 mL per patients' KG. The maximum dose is 20 mL.; Each patient, before the end of surgery, will be administered i.v. 0.1 mg of oxycodone. PCA with oxycodone (1mg/mL) will be utilized during the postoperative period: 5-minute interval.; Each patient will generally anesthetized and endotracheal tube will be inserted; Paracetamol will be given i.v. every 6 hours.
Other intervention name(s): GA
Intervention MeSH terms: Acetaminophen; Oxycodone
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: Parallel Assignment
Masking: Single (Participant)
Primary purpose: Treatment
Keywords: Erector Spinae Plane blockade; Pectoral Fascia block; patient control anlagesia; mitral valve replacement