Rhomboid Intercostal Block for Video Assisted Thoracic Surgery
Condition: Lung Diseases
MeSH terms: Lung Diseases
Study type: Interventional

Summary: 
      Video assisted thoracic surgery (VATS) has recently been evaluated as the standard surgical
      procedure for lung surgery. Analgesia management is very important for these patients in
      postoperative period since insufficient analgesia can cause pulmonary complications such as
      atelectasis, pneumonia and increased oxygen consumption.

      Rhomboid intercostal block (RIB) is a novel block and was first described by Elsharkawy et
      al. It has been reported that RIB may provide effective analgesia management for several
      surgeries like thoracotomy.
    

Detailed description: 
      Following Video Assisted Thoracic Surgery Video assisted thoracic surgery (VATS) has recently
      been evaluated as the standard surgical procedure for lung surgery. The advantages of VATS
      prodecures compared with open thoracotomy are rapid recovery, short hospital stay and low
      complication risk. Although VATS is less painful than thoracotomy, patients may feel severe
      pain during the first hours at postoperative period. Analgesia management is very important
      for these patients in postoperative period since insufficient analgesia can cause pulmonary
      complications such as atelectasis, pneumonia and increased oxygen consumption.

      Rhomboid intercostal block (RIB) is a novel block and was first described by Elsharkawy et
      al. Local anesthetic solution is administrated between the rhomboid muscle and intercostal
      muscles over the T5-6 ribs 2-3 cm medially of the medial border of the scapula. RIB targets
      both the posterior rami and lateral cutaneous branches of the thoracic nerves and provides
      analgesia for the hemithorax from T2 to T9. It has been reported that RIB may provide
      effective analgesia management for several surgeries like thoracotomy.

      The aim of this study is to evaluate the efficacy US-guided Rhomboid intercostal block
      compared to no intervention control group for postoperative analgesia management after VATS.
      The primary aim is to compare postoperative opioid consumption and the secondary aim is to
      evaluate postoperative pain scores (VAS), adverse effects related with opioids (allergic
      reaction, nausea, vomiting) and complications due to block (pneumothorax, hematoma etc).
    

Intervention name(s): Group RIB
Intervention type(s): Other
Intervention description(s): In group RIB, RIB block will be performed. Patients will be administered ibuprofen 400 mgr IV every 8 hours in the postoperative period. A patient controlled device prepared with 10 mcg/ ml fentanyl will be attached to all patients with a protocol included 10 mcg bolus without infusion dose, 10 min lockout time and 4 hour limit.
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: There are two models for this study. The first group is rhomboid intercostal block group. The second one is no intervention control group
Masking: Single (Outcomes Assessor)
Primary purpose: Treatment
Keywords: Video Assisted Thoracic Surgery; Postoperative pain management; Rhomboid intercostal block