Ultrasound-guided Block for Thoracic Surgery Pain

Study Overview
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Brief Summary
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The investigators aimed to assess Ultrasounde- guided serratus anterior plane block can be effective in acute postoperative pain following thoracic surgery.

Detailed Description
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Analgesic options for thoracotomy are various with each having their own merits and demerits.Thoracic epidural is said to be the gold standard for management of thoracotomy pain. However, it is invasive procedure and many side effects. Other options include paravertebral block, interpleural block, intrathecal opioids. Especially, paravertebral block is thought good alternative to epidural anethesia. Most of these invasive neuraxial techniques demand normal coagulation parameters to be present. The serratus anterior plane block(SAPB) was done under ultrasound guidance in the mid-axillary line at the level of the fourth rib and the catheter was placed superficial to the serratus plane. The patient expressed relief in pain within 10 minutes of being given the bolus of local anaesthetic.Pain following thoracotomy is chiefly due to rib retraction, and damage to the serratus/intercostal muscles and intercostal nerves. A SAPB addresses both these aspects. SAPB has been mentioned in previous studies for management of rib fractures and breast surgeries. The investigators try to evaluate whether the SAPB is easy to perform and provides effective analgesia in patients undergoing thoracotomy with minimal side effects.

Official Title
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Ultrasound-guided Serratus Anterior Plane Block for Thoracic Surgery Pain?

Conditions
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Postoperative Pain, Thoracic Cancer

Intervention / Treatment
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* Procedure: serratus anterior plane block
* Drug: patient controlled analgesia


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: •undergoing thoracic surgery (lobectomy or segmentectomy) Exclusion Criteria: • allergy to any drugs chronic pain disease with medication psychologic disorder anti-depressant drug chronic kidney disease ( Cr over 2.0 mg/dl) coagulopathy

Ages Eligible for Study
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Minimum Age: 20 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: Randomized
Intervention Model: Parallel Assignment
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Sham Comparator: IV-PCA group<br>no block performing, only use intravenous patient controled analgesia(IV-PCA) | Drug: patient controlled analgesia<br>* two groups have same intravenous patient controlled analgesia<br>|
| Experimental: SAPB group<br>serratus anterior plane block(SAPB) and intravenous patient controled analgesia(IV-PCA) | Procedure: serratus anterior plane block<br>* before surgery :ultrasound-guided serratus anterior plane block<br>Drug: patient controlled analgesia<br>* two groups have same intravenous patient controlled analgesia<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| opioid consumption | the dose of PCA and residual opioid | the first 24hour in postoperative phase | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| postoperative pain scale | numeric rating scale | intraoperative(immediately after surgery), postoperative 6 ,12, 24 hour | 
| opioid consumption | the dose of PCA and residual opioid | the first 6,12 hour in postoperative phase | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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serratus anterior plane block, ultrasound-guided, regional anesthesia, thoracic surgery, postoperative pain