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It is widely accepted that thoracotomy causes severe acute pain. This increases the frequency of postoperative pulmonary complications and postoperative morbidity. Many analgesic methods have been proposed for thoracotomy pain, including thoracic epidural analgesia (TEA), thoracic paravertebral block (TPVB), intercostal nerve blocks (ICSB), erector spinae plane block (ESPB), serratus anterior plane block (SAPB). Among these methods, ultrasound-guided TPVB and ESPB are the most used methods. TPVB has left its place to newer techniques such as ESPB due to its proximity to the pleura and its deeper location. ESPB is more superficial, easy to access, and less likely to have complications. In addition, ESPB application is increasing in patients who underwent thoracotomy and VATS. There is no consensus on the dose of analgesia in these studies. There are studies on volumes between 10 ml and 40 ml in the literature. In this study, it was aimed to compare the volumes of 20 ml and 30 ml containing local anesthetic at the same concentration (0.25% bupivacaine) of ESPB block to be performed with USG in patients who underwent thoracotomy.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Erector Spinae Plane Block with 20 ml %0.25 Bupivacaine | Active Comparator | Following the visualization of the anatomical structures, the nerve block needle was advanced via the in-plane technique beneath the erector spinae muscles until the interfascial space was reached. After hydrodissection with 2 ml normal saline, 20 ml 0.25% bupivacaine was injected into the area. |
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| Erector Spinae Plane Block with 30 ml %0.25 Bupivacaine | Active Comparator | Following the visualization of the anatomical structures, the nerve block needle was advanced via the in-plane technique beneath the erector spinae muscles until the interfascial space was reached. After hydrodissection with 2 ml normal saline, 30 ml 0.25% bupivacaine was injected into the area. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Same blocks with different local anesthetic volume | Procedure | Erector spinae plane block with different local anesthetic volumes will be applied to the patients under real-time ultrasound guidance. |
| Measure | Description | Time Frame |
|---|---|---|
| Pain Scores | Pain will be assessed at rest and while coughing using the visual analog scale on a scale from 0 (no pain) to 10 (worst pain). Pain assessment will be done at 1st, 2nd, 4th, 8th, 16th, 24th and 48th hours after surgery. | 48 hours after surgery |
| Measure | Description | Time Frame |
|---|---|---|
| Morphine Consumption | Morphine consumption for 24 hours will be recorded | 24 hours after surgery |
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Inclusion Criteria:
Exclusion Criteria:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Ankara Atatürk Chest Disease and Chest Surgery Training and Research Hospital | Keçiören | Ankara | 06000 | Turkey (Türkiye) |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 36747119 | Derived | Zengin M, Sazak H, Baldemir R, Ulger G, Arican D, Kaybal O, Alagoz A. Comparison of analgesic efficacy of different local anesthetic volumes for erector spinae plane block in thoracotomy patients; a prospective randomized trial. BMC Anesthesiol. 2023 Feb 6;23(1):42. doi: 10.1186/s12871-023-02004-4. |
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