Continuous Ultrasound Guided Erector Spinae Plane Block vs Thoracic Paravertebral Block

Study Overview
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Brief Summary
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in this study the investigators will investigate and compare the analgesic efficacy of two techniques (continuous TPVB and continuous ESPB) in relieving thoracotomy pain

Detailed Description
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General Anesthesia will be induced with Fentanyl (1-2 μg/kg), Propofol (2-3 mg/kg), and Atracurium (0.5-0.8 mg/kg). Pressure controlled Volume guarantee Ventilation mode will be used to maintain O2 Saturation Above 98% and End tidal co2 Around 30-35 mmHg. Anesthesia will be maintained with Isoflurane 1.2 Minimum Alveolar Concentration inhalation after induction Group A: Patients will receive Loading dose of 20 ml 0.25% bupivacaine then continuous infusion U/S-Guided TPVB of 5 ml/h of 0.125% bupivacaine started through the catheter before the surgical procedure intraoperative and Group B: Patients will receive Loading dose of 20 ml 0.25% bupivacaine then continuous U/S-Guided ESPB of 5 ml/h of 0.125% bupivacaine started through the catheter before the surgical procedure intraoperative.

Official Title
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Continuous Ultrasound Guided Erector Spinae Plane Block vs Thoracic Paravertebral Block for Postoperative Analgesia in Patients Undergoing Thoractomy

Conditions
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Postoperative Pain

Intervention / Treatment
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* Other: continuous Thoracic paravertebral block
* Other: continuous Erector spinae plane block


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: - Eligible 40 patients will be older than 21 years old with American society of anesthesia physical status I& II scheduled for elective thoracotomy Exclusion Criteria: Patients who are: Uncooperative. Having allergy to any of the study drugs. Known abuse of alcohol or medication. Having Local infection at the site of injection or systemic infection. Pregnancy. With coagulation disorders or on anticoagulation therapy

Ages Eligible for Study
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Minimum Age: 21 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Other
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: Group A<br>Patients will receive Loading dose of 20 ml 0.25% bupivacaine then continuous infusion U/S-Guided TPVB of 5 ml/hr of 0.125% bupivacaine started through the catheter before the surgical procedure intraoperative | Other: continuous Thoracic paravertebral block<br>* continuous infusion U/S-Guided TPVB of 5 ml/hr of 0.125% bupivacaine started through the catheter before the surgical procedure intraoperative.<br>* Other names: TPVB;|
| Active Comparator: Group B<br>Patients will receive Loading dose of 20 ml 0.25% bupivacaine then continuous U/S-Guided ESPB of 5 ml/hr of 0.125% bupivacaine started through the catheter before the surgical procedure intraoperative. | Other: continuous Erector spinae plane block<br>* continuous U/S-Guided ESPB of 5 ml/hr of 0.125% bupivacaine started through the catheter before the surgical procedure<br>* Other names: ESPB;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Compare the VAS score postoperative of (U/S)-guided continuous (ESPB) to continuous (TPVB) following thoracotomy | visual analogue scale (VAS) Score | 48 hours | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| 1 st call analgesia | mg | 1 hour | 
| Total rescue opioid dose used | mg | 48 hour | 
| patient satisfaction at 24 hours |  | 24 hours | 
| occurrence of adverse events |  | 24hours | 
| hospital stay | days | 1 week |