Clinical trial NCT05521789: Erector Spinae Block for Thoracic Surgery
Official title: Erector Spinae Blocks for Thoracic Surgery
Study type: INTERVENTIONAL
Overall status: RECRUITING
Phase: PHASE4
Conditions: Pulmonary Neoplasm
Pulmonary Cancer
Thoracic Diseases
Thoracic Cancer
Thoracic Neoplasms
Lead sponsor: George Washington University
Sponsor class: OTHER
First posted: 2022-08-30
Enrollment: 70
Sex: ALL
Minimum age (years): 18
Maximum age (years): 90
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: TREATMENT

Brief summary: The aim of this study is to determine if erector spinae injections with bolus infusions with local anesthetic decrease postsurgical pain and opioid consumption in patients undergoing pulmonary resection surgery.

Detailed description: The research hypothesis for the ESB Thoracic study is that erector spinae blocks with boluses of bupivacaine infusions will decrease patients' postsurgical pain, and thereby decrease the amount of narcotic pain medication used. This will be of particular use in patients who have an anticoagulation need and are not able to receive more invasive nerve blocks.To achieve appropriate exposure for pulmonary resection surgery, whether open or video-assisted, patients have surgical incision in the lateral thoracic region, including disruption to the tributaries of the spinal nerves. Due to this dissection, patients frequently experience significant pain post-operatively. Erector spinae blocks with bupivacaine or ropivacaine with bolus infusion therapy have been shown to treat this spinal nerve pain effectively in rib fractures, thoracoscopic surgeries, and breast surgeries. However, there have been no definitive studies evaluating the effectiveness of erector spinae blocks in postoperative pulmonary resection surgery patients.

It is expected that patients with erector spinae blocks (ESB) will have lower pain visual analogue scores (VAS) and lower total opioid consumption. Learning more about the effectiveness of ESB can help in providing adjunct therapy and thereby minimize post-operative opioids, use of which can add further complications in this group of patients through decreased ventilation and increased atelectasis and hypercarbia. As well, current neuraxial local anesthetic therapy involving epidurals and paravertebral blocks require an absence of anticoagulation in the patient; as a fascial plane block, erector spinae blocks can be safely placed in patients on anticoagulation.

Eligibility criteria: Inclusion Criteria:

* pulmonary resection
* 18\<age\<90

Exclusion Criteria:

* pleurodesis
* decortication
* emergent surgery
* local anesthetic allergy
* intraoperative complication (inadvertent hemorrhage or conversion to open surgery)
* bilateral pulmonary resection

Primary outcomes:
measure: Outcome Measure - Pain Score and Pain Medications (6 hours)
timeFrame: At 6 hours postoperatively
measure: Outcome Measure - Pain Score and Pain Medications (12 hours)
timeFrame: At 12 hours postoperatively
measure: Outcome Measure - Pain Score and Pain Medications (24 hours)
timeFrame: At 24 hours postoperatively
Secondary outcomes:
Other outcomes:
Locations:
city: Washington
country: United States
facility: The George Washington University
state: District of Columbia
Study officials:
References: