The Effects of Body Mass Index on Thoracic Paravertebral Block Analgesia

Study Overview
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Brief Summary
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Obesity has become one of the world's leading health problems. It is known that obesity causes many diseases and negatively affects the quality of life. For this reason, many conditions that are thought to be effective in obesity and concern the quality of life of patients have been scientifically researched and continue to be investigated. One of them is postoperative pain. Although there are studies stating that there is no relationship between body mass index (BMI) and postoperative pain, when the literature data is examined, it is thought that obesity is a risk factor for postoperative pain and changes pain sensitivity and analgesic needs of patients. There are also studies in the literature stating that the level of postoperative pain increases in parallel with each unit increase in BMI. After thoracic surgery, many analgesic methods have been suggested, including thoracic epidural analgesia (TEA), thoracic paravertebral block (TPVB), intercostal nerve blocks (ICSB), erector spina plane block (ESPB), serratus anterior plane block (SAPB). This study will compare the effects of BMI on postoperative pain in patients undergoing TPVB for postoperative analgesia and thoracoscopic surgery.

Official Title
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The Effects of Body Mass Index on Thoracic Paravertebral Block Analgesia Treatment in Patients Undergoing Thoracoscopic Surgery

Conditions
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Pain, Postoperative, Acute Pain, Thoracic Paravertebral Block, Body Mass Index, Thoracic Surgery, Video-Assisted

Intervention / Treatment
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* Procedure: Thoracic Paravertebral Block


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: 18 to 80 years old ASA physical status I-II-III BMI 18 to 40 kg/m2 Elective video-assisted thoracoscopic surgery Exclusion Criteria: Patient refusing the procedure Emergency surgery Chronic opioid or analgesic use Patients who will operate under emergency conditions Patients who will not undergo VATS

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 80 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: Non-Randomized
Intervention Model: Parallel Assignment
Masking: Quadruple


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: Patients with a BMI of 18-24.9 kg/m2<br>The needle will be advanced to the paravertebral area with an ultrasound-guided in-plane technique. 30 ml of 0.25% bupivacaine will be injected into this area. | Procedure: Thoracic Paravertebral Block<br>* Thoracic paravertebral block will be applied to the patients under real-time ultrasound guidance.<br>|
| Active Comparator: Patients with a BMI of 25-29.9 kg/m2<br>The needle will be advanced to the paravertebral area with an ultrasound-guided in-plane technique. 30 ml of 0.25% bupivacaine will be injected into this area. | Procedure: Thoracic Paravertebral Block<br>* Thoracic paravertebral block will be applied to the patients under real-time ultrasound guidance.<br>|
| Active Comparator: Patients with a BMI of 30-40 kg/m2<br>The needle will be advanced to the paravertebral area with an ultrasound-guided in-plane technique. 30 ml of 0.25% bupivacaine will be injected into this area. | Procedure: Thoracic Paravertebral Block<br>* Thoracic paravertebral block will be applied to the patients under real-time ultrasound guidance.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Pain Scores | Pain will be assessed at the first-hour rest and while coughing using the visual analog scale on a scale from 0 (no pain) to 10 (worst pain). Pain assessment will be done at the 1st, 2nd, 4th, 12th, 24th, and 48th hours after surgery. | 1st hour after surgery. | 
| Pain Scores | Pain will be assessed at the 2nd-hour rest and while coughing using the visual analog scale on a scale from 0 (no pain) to 10 (worst pain). | 2nd-hour after surgery. | 
| Pain Scores | Pain will be assessed at the 4th-hour rest and while coughing using the visual analog scale on a scale from 0 (no pain) to 10 (worst pain). | 4th-hour after surgery. | 
| Pain Scores | Pain will be assessed at the 12th-hour rest and while coughing using the visual analog scale on a scale from 0 (no pain) to 10 (worst pain). | 12th-hour after surgery. | 
| Pain Scores | Pain will be assessed at the 24th-hour rest and while coughing using the visual analog scale on a scale from 0 (no pain) to 10 (worst pain). | 24th-hour after surgery. | 
| Pain Scores | Pain will be assessed at the 48th-hour rest and while coughing using the visual analog scale on a scale from 0 (no pain) to 10 (worst pain). | 48th-hour after surgery. | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Morphine Consumption | Morphine consumption for 24 hours will be recorded | 24 hours after surgery |