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The objective is to investigate the safety and effectiveness of rhomboid intercostal and subserratum plane (RISS) block for postoperative analgesia after minimally invasive McKeown esophagectomy (MIE-McKeown).
Rhomboid intercostal and subserratum plane block (RISS) is a nerve block technique in which local anesthetics are injected into the rhomboid-intercostal muscle planes and the serratus anterius-intercostal muscle planes, and the intercostal nerve is blocked by diffusion of local anesthetics. It is confirmed that RISS can provide analgesia not only in the front half of the chest, but also in the upper abdomen. However, the efficacy of RISS in minimally invasive surgery for esophageal cancer has not been proven. The investigators placed catheters on the RISS plane and continuously injected local anesthetics to investigate whether RISS is effective and safe in minimally invasive esophageal cancer surgery.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| continuous RISS group | Experimental | Patients were given continuous RISS plane block in addition to patient controlled intravenous analgesia. |
|
| single RISS group | Experimental | Patients were given single RISS plane block in addition to patient controlled intravenous analgesia. |
|
| PCIA group | Active Comparator | Patients were given patient controlled intravenous analgesia. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Catheterization | Procedure | Before the operation,the patient was placed in the left lateral position.The catheter（soft tip epidural catheter 20-gauge-100 cm） was placed at the rhomboid-intercostal plane under ultrasound guidance at the T5-T6 level, followed by ultrasound-guided catheter placed in the anterior serrated muscle plane at the T7-9 level。 |
| Measure | Description | Time Frame |
|---|---|---|
| Analgesic effect | patient will be asked to rate their pain level at rest and cough respectively using visual analogue scale（VAS）.(0 being no pain, 10 being worst pain imaginable) | 2, 6, 12, 24, and 48 hours after surgery |
| mean arterial pressure (MAP) | The mean arterial pressure (MAP)on the monitor at different times was recorded. | before anesthesia induction (T0)， before skin incision（T1）， 5 minutes after skin incision |
| Heart rate (HR) | The Heart rate (HR)on the monitor at different times was recorded. | before anesthesia induction (T0)， before skin incision（T1）， 5 minutes after skin incision |
| Measure | Description | Time Frame |
|---|---|---|
| dizziness | The occurrence of dizziness was recorded | 24hours after surgery |
| lethargy | The occurrence of lethargy was recorded | 24hours after surgery |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Luo fuchao, MD | Contact | +8613896658090 | luokyyx@163.com |
| Name | Affiliation | Role |
|---|---|---|
| Luo fuchao, MD | Chongqing University Fuling Hospital | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| FulingCH | Recruiting | Chongqing | China |
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| ID | Term |
|---|---|
| D004938 | Esophageal Neoplasms |
| ID | Term |
|---|---|
| D005770 | Gastrointestinal Neoplasms |
| D004067 | Digestive System Neoplasms |
| D009371 | Neoplasms by Site |
| D009369 | Neoplasms |
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| ID | Term |
|---|---|
| D002404 | Catheterization |
| D009407 | Nerve Block |
| ID | Term |
|---|---|
| D013812 | Therapeutics |
| D008919 | Investigative Techniques |
| D000765 | Anesthesia, Conduction |
| D000758 | Anesthesia |
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|
| Single nerve block | Procedure | Before the operation,40milliliters of 0.3% ropivacaine was injected into the rhomboid-intercostal fascia plane and anterior serrated muscle plane respectively under the guidance of ultrasound. |
|
| Continuous nerve block | Procedure | After surgery,local anesthetics were injected continuously through catheters.Local anesthetic formula:Ropivacaine 300mg + normal saline, prepared into 150milliliters liquid, background dose 2milliliters/h. |
|
| PCIA | Procedure | After surgery, the patient was given controlled intravenous analgesia. Analgesic pump drug formula:Sufentanil 50ug+ Dezocine 20mg+ Granisetron 10mg+150milliliters saline, continuous dose of 2milliliters/h intravenous pump, single injection dose of 2milliliters, locking time of 20 min |
|
| nausea or vomiting | The occurrence of nausea /vomiting was recorded | 24hours after surgery |
| hypotension | The occurrence of hypotension was recorded | 24hours after surgery |
| respiratory depression | The occurrence of respiratory depression was recorded | 24hours after surgery |
| urinary retention | The occurrence of urinary retention was recorded | 24hours after surgery |
| Analgesia satisfaction | patient will be asked to rate their Satisfaction with analgesia using verbal rating scales (VRS) .Scores from 1 to 5 represent very dissatisfied, not satisfied, basically satisfied, relatively satisfied, and very satisfied with the analgesic effect, respectively. | 24hours after surgery |
| D006258 |
| Head and Neck Neoplasms |
| D004066 | Digestive System Diseases |
| D004935 | Esophageal Diseases |
| D005767 | Gastrointestinal Diseases |
| D000760 |
| Anesthesia and Analgesia |
| D003714 | Denervation |
| D019635 | Neurosurgical Procedures |
| D013514 | Surgical Procedures, Operative |