Postoperative Analgesia y After Uniportal Video-assisted Thoracoscopic Surgery

Study Overview
=================
Brief Summary
-----------------
Ultrasound-guided erector spinae plane block (ESPB) is an interfascial blockade during thoracic anesthesia, first described by Forero in 2016, and is highlighted by technically feasibility and less complication rate. The patient is placed as decubitus position. The anesthesiologists use echo to identify the ipsilateral transverse process at T5 level, and insert the needle to 2-3 cm lateral to the spinous process until contact the transverse process. Then the injected local anesthetic will penetrate via erector spinae muscle to paravertebral space to affect and relieve pain.

Official Title
-----------------
Comparison of Surgical Thoracoscopic Intercostal Nerve Block and Ultrasound-guided Erector Spinae Plane Block for Postoperative Analgesia and Enhanced Recovery After Uniportal Video-assisted Thoracoscopic Surgery: a Double-blinded, Randomized Controlled Trial

Conditions
-----------------
Post-operative Pain, Acute, Post-operative Pain, Thoracic Diseases, Post-Op Complication

Intervention / Treatment
-----------------
* Procedure: Ultrasound-guided erector spinae plane block
* Procedure: surgical thoracoscopic intercostal nerve block


Participation Criteria
=================
Eligibility Criteria
-----------------
Inclusion Criteria: adult patients, over 20 years old, u undergoing elective uniportal VATS lobectomy. Exclusion Criteria: patient refusal, body mass index > 35 kg/m2, American society of anesthesiologists (ASA) grade above 3, contraindication to nerve block, allergy to analgesic agents, regular opioid used for chronic pain prior to this time surgery, conversion to thoracotomy or VATS procedure, postoperative intubation, postoperative intensive care unit admission.

Ages Eligible for Study
-----------------
Minimum Age: 20 Years

Sexes Eligible for Study
-----------------
All

Accepts Healthy Volunteers
-----------------
No

Study Plan
=================
How is the study designed?
-----------------

Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: post-operative VAS score of Ultrasound-guided erector spinae plane block<br> | Procedure: Ultrasound-guided erector spinae plane block<br>* Ultrasound-guided erector spinae plane block<br>|
| Active Comparator: post-operative VAS score of surgical thoracoscopic intercostal nerve block<br> | Procedure: surgical thoracoscopic intercostal nerve block<br>* surgical thoracoscopic intercostal nerve block<br>|

What is the study measuring?
-----------------
Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Visual analogue scale | post-op VAS score, 0-10, the higher means painful, and 0 point no pain. | post-op 2 days | 
| accumulated morphine usage dose | accumulated morphine usage dose | post-op 2 days | 

 Terms related to the study
=================
Keywords Provided by Centre Hospitalier Valida
-----------------
Uniportal video-assisted thoracoscopic surgery, Ultrasound-guided erector spinae plane block, surgical thoracoscopic intercostal nerve block, cumulative intravenous morphine consumption, visual analogue scale, Enhanced Recovery After Surgery