Thoracic Paravertebral Block : Effect on Acute Pain and Chronic Pain of Hepatectomy With Right J-shape Subcostal Incision

Study Overview
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Brief Summary
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This prospective, randomized study,control study aims to compare the analgesic effect,opioids consumption,quality of recovery,length of hospital stay and incidence of chronic pain,et al. single-injection TPVB +continuous(pulsatile infusion) TPVB and intravenous patient-controlled analgesia (IPCA) alone in patients undergoing hepatectomy with right J-shape subcostal incision.

Conditions
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Hepatectomy, Analgesia, Nerve Block

Intervention / Treatment
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* Procedure: single-injection TPVB + continuous TPVB
* Device: Philip CX50 Ultrasound Scanner
* Device: PAJUNK Contiplex S Catheter
* Drug: single dose ropivacaine
* Drug: continuously infusion of ropivacaine
* Drug: Morphine given as IPCA


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Age 18-70 yrs American Society of Anesthesiologists physical statusⅠ-Ⅲ Undergo hepatectomy with J-shape subcostal incision Informed consent Exclusion Criteria: A known allergy to the drugs being used Coagulopathy, on anticoagulants Analgesics intake, history of substance abuse Participating in the investigation of another experimental agent Inability to properly describe postoperative pain to investigators (eg, language barrier, neuropsychiatric disorder)

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 70 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: Supportive Care
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Single-injection TPVB +continuous TPVB<br>Single-injection of TPVB is given preoperatively followed with continuous infusion+ postoperative IPCA. | Procedure: single-injection TPVB + continuous TPVB<br>* Inject local anesthetics in the T8 paravertebral space followed with catheter insertion and continuous local infusion.<br>Device: Philip CX50 Ultrasound Scanner<br>* The curved (C1-5) probe of Philip CX 50 Ultrasound Scanner is used for scanning<br>Device: PAJUNK Contiplex S Catheter<br> <br> Drug: single dose ropivacaine<br>* 2mg/kg ropivacaine in saline with 1:200,000 adrenaline, 25ml in total given immediately after the correct position of the tip of the needle has been confirmed<br>Drug: continuously infusion of ropivacaine<br>* 0.2% ropivacaine, pulse dosadge: 0.125ml/kg/pulse, 1pulse/h at a rate of 6ml/minutes given through the catheter inserted in the T8 paravertebral space following the single dose<br>Drug: Morphine given as IPCA<br>* bolus: 2mg, lock time: 10min, 1h limitation: 8mg<br>|
| Active Comparator: IPCA<br>postoperative IPCA is given alone | Drug: Morphine given as IPCA<br>* bolus: 2mg, lock time: 10min, 1h limitation: 8mg<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| cumulative morphine consumption |  | within 48 postoperative hours | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| The pain scores determined by the numeric rating scale (NRS, 0-10) |  | At 0, 2,4, 8, 12, 24 ,48,72hours and 7day after the surgery | 
| nausea and vomiting score |  | At 0, 2,4, 8, 12, 24 and 48hours after the surgery | 
| pruritus score |  | At 0, 2,4, 8, 12, 24 and 48hours after the surgery | 
| ambulation time |  | within the 7 days after surgery | 
| time of recovery of bowl movement |  | within the 7 days after surgery | 
| Postoperative hospital length of stay |  | Up to 4 weeks | 
| patient satisfaction with anesthesia | use the Chinese version Bauer questionnaire to assess the patient satisfaction with anesthesia | 48 hours after surgery | 
| data collection of chronic pain | Patients undergo a telephone interview with a questionnaire at 3, 6 and 12 months after surgery, the incidence and severity of chronic pain is recorded. | at 3,6,12 months after surgery |