Patient Controlled Erector Spinae Block at VATS
Condition: Postoperative Pain
MeSH terms: Pain, Postoperative
Study type: Interventional

Summary: 
      In this study our aim is to investigate the effects of continue erector spinae block on
      postoperative pain in patients who underwent thoracoscopic surgery.
    

Detailed description: 
      Open thoracic surgeries are very painful procedures. After these procedures multimodal
      analgesia methods such as NSAIDs, opioids, PCA (patient-controlled analgesia), infiltration
      analgesia and thoracal epidural block are frequently used. Of these methods thoracal epidural
      block is the gold standart, however this technique is very invasive and has a high risk for
      complications. Lately Video Assisted Thoracoscopic Surgery (VATS) has become more popular
      because it reduces the hospital stay and is less invasive, hence the thoracic epidural block
      for postoperative pain has become more questionable. In this study we aimed to investigate
      the effects of continue Erector Spinae Block (ESB) on postoperative pain after VATS. The
      study will include 80 patients.

      40 patients will receive ultrasound (USG) guided ESB and 40 patients will receive PCA.

      All patients will recive IV Midazolam (0.05mg/kg) premedication. Standard monitorization of
      EKG, non- invasive blood pressure and pulsoximeter will be done and recorded in every 5
      minutes. Fentanyl (1-2 µg/kg), Propofol (2-3 mg/kg) and Rocuronyum (0,5-0,8 mg/kg) will be
      given in induction of general anesthesia. Volume -controlled ventilation will be secured to
      have the values O2 saturation >98% and en-tidal carbondioxide 30-35 mm-Hg. For the
      mainentanance of general anesthesia the minimal alveolar concentration of sevoflurane will be
      1. After the surgery every patient will receive 1 gr paracetemol and 100 mg tramadol for
      postoperative pain. Furthermore every patient will receive 8 mg ondansetrone for
      postoperative nausesa.

      After sedation and standard monitorization, 20 minutes before the induction and in the prone
      position the Erecor Spinae Block (ESB) procedure will be done. 10 % povidone - iodin will be
      used for sterilization and the USG probe will be covered with sterile sheath. The block will
      be done at the 8th thoracic vertebra line. The USG probe will be replaced 2-3 cm lateral to
      the spinous process in sagittal plane. When the erector spinae muscle is identifed in the USG
      the needle will be guided caudally. 0.5-1 ml local anesthetics will be given in order to
      confirm the needle is in the right place. After confirmation with 20 mL %0.25 bupivacaine the
      procedure will be performed. The patients' VAS scores will be evaluated at the 1st,3rd, 6th,
      12th, and 24th hours and will be recorded.
    

Intervention name(s): VIDEO ASSISTED THOTACOSOPIC SURGERY
Intervention type(s): Procedure
Intervention description(s): VATS
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: The study will be a two-arm parallel assignment. One group will receive erector spinae block and the other will receive PCA.
Masking: Single (Participant)
Primary purpose: Treatment
Keywords: Erector Spinae Block,; VATS