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A thoracotomy requires a very painful incision, involving multiple muscle layers, rib resection and continuous motion as the patient breathes. Treatment of acute post thoracotomy pain is particularly important not only to keep the patient comfortable but also to minimize pulmonary complications
Though epidural analgesia was once considered as the gold standard for post-thoracotomy pain management, it is not recommended for pain control after thoracotomy surgery because it is associated with high potential risks of dural puncture, nerve lesions, epidural hematoma and hypotension(4). Thoracic paravertebral block (TPVB) and intercostal nerve block are well described and recognized techniques for postoperative analgesia following thoracic surgeries, such as thoracotomy and mastectomy
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Group CTB | Active Comparator | n=30): patients included in this group will receive unilateral US-guided CTB after general anesthesia. The CTB will be performed by using 20 ml bupivacaine 0.25% |
|
| Group ESPB | Active Comparator | patients included in this group will receive unilateral US-guided ESPB after general anesthesia. The ESB will be performed by using 20 ml bupivacaine 0.25% |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Bupivacaine 0.25% Injectable Solution | Drug | Group CTB (n=30): patients included in this group will receive unilateral US-guided CTB after general anesthesia. The CTB will be performed by using 20 ml bupivacaine 0.25% Group ESPB (n=30): patients included in this group will receive unilateral US-guided ESPB after general anesthesia. The ESB will be performed by using 20 ml bupivacaine 0.25% |
| Measure | Description | Time Frame |
|---|---|---|
| study aims to compare the analgesic efficacy of CTB and ESPB for post-operative analgesia in patients undergoing thoracotomy. | study aims to compare the analgesic efficacy of CTB and ESPB for post-operative analgesia in patients undergoing thoracotomyA standardized analgesic regimen will be prescribed in the post-operative period. All patients will receive paracetamol 1 gm every 6 h as routine analgesia. If visual analogue scale (VAS) is more than 3, intravenous morphine 3mg will be administered as rescue analgesia If visual analogue scale (VAS) is more than 5 | 5months |
| Measure | Description | Time Frame |
|---|---|---|
| The secondary outcome is the total postoperative morphine consumption, time of first analgesic, | The secondary outcome is the total postoperative morphine consumption, time of first analgesic A standardized analgesic regimen will be prescribed in the post-operative period. All patients will receive paracetamol 1 gm every 6 h as routine analgesia. If visual analogue scale (VAS) is more than 3, intravenous morphine 3mg will be administered as rescue analgesia If visual analogue scale (VAS) is more than 5 |
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Inclusion Criteria:
• Age from 18 to 75 years old.
Exclusion Criteria:
• BMI more than 30 kg/m2.
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| ahmed M mokhar, Resident | Contact | 01121695985 | ahmedmokhtar@med.sohag.edu.eg | |
| wesam A Abo Elwafa Sallam, Assistant professor | Contact | 01120623333 |
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| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 34764841 | Background | Mijatovic D, Bhalla T, Farid I. Post-thoracotomy analgesia. Saudi J Anaesth. 2021 Jul-Sep;15(3):341-347. doi: 10.4103/sja.SJA_743_20. Epub 2021 Jun 19. | |
| 37927993 | Background | Liu Y, Xiao S, Yang H, Lv X, Hou A, Ma Y, Jiang Y, Duan C, Mi W; CAPOPS Group. Postoperative pain-related outcomes and perioperative pain management in China: a population-based study. Lancet Reg Health West Pac. 2023 Jun 10;39:100822. doi: 10.1016/j.lanwpc.2023.100822. eCollection 2023 Oct. |
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| Type | Date | Date Unknown |
|---|---|---|
| Release | Jun 25, 2025 | |
| Reset | Jul 14, 2025 |
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| Release Date | Unrelease Date | Unrelease Date Unknown | Reset Date | MCP Release Number |
|---|---|---|---|---|
| Jun 25, 2025 | Jul 14, 2025 |
| ID | Term |
|---|---|
| D002045 | Bupivacaine |
| ID | Term |
|---|---|
| D000813 | Anilides |
| D000577 | Amides |
| D009930 | Organic Chemicals |
| D000814 | Aniline Compounds |
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|
| 5months |
| 37065951 | Background | Singariya G, Kamal M, Paliwal B. Pain after thoracotomy: Conquered or to be conquered? Indian J Anaesth. 2023 Feb;67(Suppl 1):S12-S14. doi: 10.4103/ija.ija_90_23. Epub 2023 Feb 10. No abstract available. |
| 32502778 | Background | Huang W, Wang W, Xie W, Chen Z, Liu Y. Erector spinae plane block for postoperative analgesia in breast and thoracic surgery: A systematic review and meta-analysis. J Clin Anesth. 2020 Nov;66:109900. doi: 10.1016/j.jclinane.2020.109900. Epub 2020 Jun 2. |
| D000588 |
| Amines |