Effects of Erector Spina Plane Block and Paravertebral Block on Early Postoperative Pulmonary Function Test Parameters
NCT Number: NCT06584201
Status: RECRUITING
Study Type: OBSERVATIONAL
Conditions: Respiratory Function Loss|Pain, Postoperative|Opioid Use
Interventions: PROCEDURE: Erector Spinae Plane Block (ESP)|PROCEDURE: Paravertebral Block (PVB)
Sponsor: Başakşehir Çam & Sakura City Hospital
Sex: ALL
Age: ADULT, OLDER_ADULT
Enrollment: 70
Study Design: Observational Model: |Time Perspective: p
Start Date: 2023-11-01
Completion Date: 2024-10-01
Locations: Basaksehir Çam Ve Sakura City Hospital, Istanbul, Turkey

Summary:
The pain experienced by participants after minimally invasive chest surgery (VATS) can make it difficult for them to take deep breaths, which can lead to problems with lung function. This can cause serious problems such as lung collapse, low oxygen levels, and infections, making recovery longer and more difficult. Managing pain well after surgery is important to prevent these problems and speed up recovery. In this study, we aimed to compare two pain relief methods, Erector Spinae Plane Block (ESP) and Paravertebral Block (PVB), in participants who underwent VATS. We will look at which method causes the smallest change in lung function before and after surgery.

Primary Outcome Measures: Effectiveness on respiratory functions, All adult participants undergoing video-assisted thoracoscopic surgery (VATS) will have a preoperative pulmonary function test (PFT) conducted by an anesthetist using a portable device within the Thoracic Surgery service. The tests will be evaluated using a color-coded compliance chart: Red (Non-compliant), Yellow (Moderately compliant), Green (Compliant). The test will be repeated until compliance is achieved, with Yellow and Green results recorded. Postoperatively, PFTs will be repeated at 0, 6, 24 hours, and before discharge. The specific pulmonary function tests assessed include Forced Vital Capacity (FVC), Forced Expiratory Volume in 1 second (FEV1), Peak Expiratory Flow (PEF), Forced Expiratory Flow at 25-75% (FEF25-75), and the FEV1/FVC ratio. Each test will be reported as separate outcome measures. Respiratory function tests will be conducted 24 hours before surgery and then postoperatively at the specified intervals., Respiratory function tests will be performed 24 hours before surgery and at 0, 6, and 24 hours postoperatively, as well as before discharge. The average length of stay is 2 days, and for extended stays, the 48-hour data will be used as a baseline.
Secondary Outcome Measures: Effect on total narcotic analgesic consumption, After the surgery, participants will receive intravenous patient-controlled analgesia (PCA) and infusion will begin simultaneously with the end of the operation. "Morphine" was preferred as the treatment method to be used in the PCA method. In PCA preparation, 30 mg morphine is added to 100 cc of physiological saline. As the PCA protocol, 3 mg loading dose, 1 cc/hour (0.3 mg/hour) basal infusion dose, 3 cc (1 mg) bolus dose, 10-minute lockout period (maximum 2 bolus doses in 1 hour) were set. The total number of bolus doses administered by the participants on the PCA device at the end of 24 hours will be recorded and evaluated as the amount of additional opioid needed., Total dose administered at the end of 24 hours of the intravenous PCA device inserted simultaneously after surgery
Other Outcome Measures: Effectiveness on pain scores, Postoperative pain assessment is made using visual pain scoring. Participants are asked about their resting pain 0, 1, 4, 6, 12 and 24 hours after applying a postoperative peripheral nerve block. With this method, participants rate their pain with a precise numerical value from 0 to 10. While zero(0) represents "no pain"; Ten (10) represents the opposite end of the pain continuum (e.g., "The most intense pain imaginable," "As intense pain as possible," "unbearable pain")., 0, 1, 4, 6, 12 and 24 hours after surgery