The Effects of Three Different Ultrasound-guided Nerve Blocks in VATS

Study Overview
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Brief Summary
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Ultrasound-guided mid-point transverse process to pleura block, erector spinae plane block and paravertebral block are three different methods of nerve block, used for relieving postoperative pain in thoracic anesthesia. This study is to compare them on block effects, postoperative pain and analgesic consumption in video-assisted thoracic surgery.

Detailed Description
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Ultrasound-guided nerve block is an important part of multi-mode analgesia to decrease the consumption of opioids. Thoracic paravertebral block is considered as an ideal regional analgesic choice for video-assisted thoracic surgery, but it still has some side effects, such as pneumothorax, vascular injury, especially for novices. Recent years, ultrasound-guided mid-point transverse process to pleura block and erector spinae plane block are reported for thoracic surgery. The insertion depth in these two methods is more superficial than traditional paravertebral block. They could have less side effects. Therefore, we design a randomised control study to compare them on block effects, postoperative pain and analgesic consumption in video-assisted thoracic surgery.

Official Title
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The Effects of Ultrasound-guided Mid-point Transverse Process to Pleura Block, Erector Spinae Plane Block and Paravertebral Block on Postoperative Pain in Video-assisted Thoracic Surgery

Conditions
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Nerve Block, Thoracic Anesthesia, Pain, Acute

Intervention / Treatment
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* Procedure: Paravertebral block
* Procedure: ESP block
* Procedure: MTP block


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: selective lobetomy under VATS ASA classfication 1-3 Exclusion Criteria: history of thoracic surgery double lateral VATS allergy to local anesthetics coagulation disorders severe heart diseases, hepatic or renal insufficiency a history of chronic pain or chronic opioid use psychiatric disease or uncooperative BMI>28 kg/m2 VATS transfered to open thoractomy

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: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Triple


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: paravertebral block<br>Patients receive ultrasound-guided paravertebral block | Procedure: Paravertebral block<br>* Patients receive ultrasound-guided paravertebral block<br>|
| Active Comparator: ESP block<br>Patients receive ultrasound-guided erector spinae plane (ESP) block | Procedure: ESP block<br>* Patients receive ultrasound-guided erector spinae plane (ESP) block<br>|
| Experimental: MTP block<br>Patients receive ultrasound-guided mid-point transverse process to pleura (MTP) block | Procedure: MTP block<br>* Patients receive ultrasound-guided mid-point transverse process to pleura (MTP) block<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| postoperative morphine consumption | The dose is according to the record from PCA pump | postoperative 24 hours | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Pain score at rest | measured by VAS (0-10) | at 0, 8, 24 hour after surgery | 
| Pain score while coughing | measured by VAS (0-10) | at 0, 8, 24 hour after surgery | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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ultrasound-guided nerve block, postoperative pain