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First rib resection surgery for thoracic outlet syndrome is associated with an intense postoperative pain. It leads to significant consumption of nonsteroidal anti-inflammatory drugs and opioids, and hospitalization for several days.
In our center, first rib resection surgery was usually performed under general anesthesia combined with diffuse local infiltration of the axillary fossa. Erector spinae block is an interfascial block where a local anesthetic is injected between the erector spinae muscle and the transverse process, in order to obtain a multimetameric analgesia. It has now shown its efficacy and its safety in thoracic and abdominal surgeries by decreasing the morphine consumption and pain scores. Since November 2018, this erector spinae block is systematically performed preoperatively for first rib resection in our center, in association with a general anesthesia. Patient satisfaction seems important but remains to be assessed objectively.
In a before-after study, our goal is to assess the impact of the use of erector spinae block on postoperative pain in the first rib resection surgery.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Control | Patients in this group did not receive an erector spinae block. Data are obtained retrospectively (years 2017 and 2018). | ||
| Erector spinae block | Patients in this group receive an erector spinae block. Data will be obtained prospectively. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Erector spinae block | Procedure | Preoperative erector spinae block. |
|
| Measure | Description | Time Frame |
|---|---|---|
| Pain assessment at H+48 | Numerical pain rating scale: 0 (no pain at all) to 10 (worst imaginable pain) | Day 2 after surgery |
| Measure | Description | Time Frame |
|---|---|---|
| Postoperative pain assessment at other times | Numerical pain rating scale: 0 (no pain at all) to 10 (worst imaginable pain) | Hour 2, Day 1, and Day 3 after surgery |
| Total consumption of morphine (per and postoperative) |
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Inclusion Criteria:
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Patients undergoing first rib resection for thoracic outlet syndrome
| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Emmanuel Rineau, MD | Contact | +33241353951 | erineau@live.fr | |
| Siaudeau Hélène, MD | Contact | +33241353951 |
| Name | Affiliation | Role |
|---|---|---|
| Emmanuel Rineau, MD | University Hospital of Angers, France | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Département d'Anesthésie-Réanimation du CHU d'Angers | Angers | 49100 | France |
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| Hour 2, Day 1, Day 2 and Day 3 after surgery |
| Frequency of adverse effects related to morphine Frequency of morphine side effects | Hour 2, Day 1, Day 2 and Day 3 after surgery |
| Length of hospital stay | Through study completion, an average of 1 year |