Long Thoracic Nerve Blockade for Pain Treatment After Video-Assisted Thoracoscopic Surgery

Study Overview
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Brief Summary
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Video-assisted thoracoscopic surgery (VATS) provides an opportunity to penetrate the thoracic cavity by video through an incision into the chest wall and facilitate surgical operation of lung pathologies.Various regional methods of anesthesia are currently being used to achieve this goal. The aim of the study was to assess the effectiveness of Long thoracic nerve bloc on postoperative VATS analgesia.

Official Title
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Investigation of Analgesic Effect of Long Thoracic Nerve Blockade After VATS (Video-Assisted Thoracoscopic Surgery) Operation

Conditions
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Nerve Block, Video-Assisted Thoracic Surgery

Intervention / Treatment
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* Drug: Morphine Sulfate
* Drug: Bupivacaine


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patients who were in the American Society of Anesthesiologists (ASA) I-III class and underwent video-assisted thoracoscopic surgery (VATS). Exclusion Criteria: Previous history of opioid use preoperatively, Allergy to local anesthetics, The presence of any systemic infection, Uncontrolled arterial hypertension, Uncontrolled diabetes mellitus.

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 65 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Interventional Model Description: Prospective, randomized, controlled, single-blind
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Grup L<br>IV patient-controlled analgesia (PCA) morphine + Ultrasound guided Long thoracic nerve blockage with 5 ml % 0.25 bupivacaine | Drug: Morphine Sulfate<br>* Intravenous morphine infusion with PCA: Solution was concentration of 0.5 mg/mL. Loading dose of 1 mg, 0.5 mg of bolus dose and 20 min of locking time.<br>* Other names: Morphine;Drug: Bupivacaine<br>* Ultrasound guided Long thoracic nerve blockage with 5 ml % 0.25 bupivacaine<br>|
| Active Comparator: Group P<br>IV patient-controlled analgesia (PCA) morphine | Drug: Morphine Sulfate<br>* Intravenous morphine infusion with PCA: Solution was concentration of 0.5 mg/mL. Loading dose of 1 mg, 0.5 mg of bolus dose and 20 min of locking time.<br>* Other names: Morphine;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| morphine consumption | morphine consumption | Postoperative 24 hours | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Visual Analog Scale | Visual Analog Scale was used for pain.Pain intensity was measured using 0-10 cm visual analogue scale (VAS). (0=no pain, 10=intolerable pain) | Postoperative 24 hours | 
| side effect (Hypotension) | side effect Hypotension | Postoperative 24 hours | 
| additional analgesic use | additional analgesic use | Postoperative 24 hours | 
| side effect (Nausea and vomiting) | Nausea and vomiting scale 1. Nausea and vomiting scale (nausea-vomiting scale (NVS): 1. No nausea is present, 2. Mild nausea is present. 3. Severe nausea is present. 4. Vomiting is present) In case of a NVS score of >3, an anti-emetic drug was administered. | Postoperative 24 hours | 
| side effect (Ramsay Sedation Scale (RSS) | Ramsay Sedation Scale (Ramsay Sedation Scale (RSS) : 1. Anxiety, agitation are present; 2. Cooperated, awake; 3. Sedatized, response to commands; 4. Sleepy, immediately awoken by auditory stimulus or glabella tap; 5. Sleepy, deep response to auditory stimulus or glabella tap and 6. Sleepy, no response to auditory stimulus or glabella tap) | Postoperative 24 hours |