Comparison of the Clinical Efficacy of 2 Paravertebral Block Strategies in Thoracic Surgery by Thoracotomy: by the Anesthetist (Paravertebral Block Guided by Ultrasound) and by the Thoracic Surgeon (Paravertebral Block Visual)

Study Overview
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Brief Summary
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Post-thoracotomy pain is one of the most severe. The local analgesia allows its effective control and a reduction of postoperative morbidity and mortality. The gold standard for local analgesia is the thoracic epidural. However, this technique can be dangerous with severe complications. The paravertebral block showed comparable efficacy to the thoracic epidural for local analgesia . In addition, it has a better safety profile. There are several installation techniques. The difference in efficiency of these laying techniques is unknown.

Detailed Description
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Compare the clinical effectiveness of two strategies of realization of paravertebral block: by the anesthetist before incision (paravertebral block guided by ultrasound) and by the thoracic surgeon at chest closure (paravertebral block visual).

Official Title
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Comparison of the Clinical Efficacy of 2 Paravertebral Block Strategies in Thoracic Surgery by Thoracotomy: : by the Anesthetist (Paravertebral Block Guided by Ultrasound) and by the Thoracic Surgeon (Paravertebral Block Visual)

Conditions
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Pain

Intervention / Treatment
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* Other: paravertebral block by the anesthetist before incision (paravertebral block guided by ultrasound)
* Other: paravertebral block by the thoracic surgeon at chest closure (paravertebral block visual).


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: patient with thoracotomy indication for segmentectomy (s), lobectomy (s) lung or pulmonary wedge resection patient consenting to participate to the study patient enrolled in the national healthcare insurance program patient older than 18 years Exclusion Criteria: patient with neuropathy patient with body mass index superior to 35 kg/m2 patient with contraindication for paravertebral block or local analgesia

Ages Eligible for Study
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Minimum Age: 18 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 |
| --- | --- |
| Experimental: experimental group<br>paravertebral block by the anesthetist before incision (paravertebral block guided by ultrasound) | Other: paravertebral block by the anesthetist before incision (paravertebral block guided by ultrasound)<br> <br> |
| Active Comparator: control group<br>paravertebral block by the thoracic surgeon at chest closure (paravertebral block visual) | Other: paravertebral block by the thoracic surgeon at chest closure (paravertebral block visual).<br> <br> |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| pain | Pain evaluated using a visual analog pain scale | 24 hours | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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thoracic surgery, thoracotomy