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The aim of this study is to compare the effectiveness of analgesia achieved by external oblique intercostal plane block (EOIPB)and thoracic paravertebral block (TPVB) for postoperative pain management in patients undergoing open thoracotomy.
Acute thoracotomy pain is multifactorial in nature. It involves nociceptive and neuropathic mechanisms originating from somatic and visceral afferents. The main sources of pain are intercostal nerves, the vagus nerve and phrenic nerve in the pleura, the superficial cervical plexus, and the brachial plexus in the ipsilateral shoulder.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| External oblique intercostal plane block | Experimental | Patients will receive external oblique intercostal plane block. |
|
| Thoracic paravertebral block | Experimental | Patients will receive thoracic paravertebral block. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| External oblique intercostal plane block | Other | Patients will receive external oblique intercostal plane block |
|
| Measure | Description | Time Frame |
|---|---|---|
| Total morphine consumption | Rescue analgesia of morphine will be given as 2 mg bolus if the numeric rating scale (NRS) > 3 to be repeated after 30 min if pain persists until the numeric rating scale < 4. numeric rating scale will be assessed at 0, 4, 8, 12, 18 and 24h postoperatively. | 24 hours postoperatively |
| Measure | Description | Time Frame |
|---|---|---|
| Intraoperative fentanyl consumption | Additional fentanyl bolus dosages of 1 µg/kg IV will be administered if heart rate or mean arterial blood pressure elevated more than 20% of the baseline (after exclusion of other causes than pain). | Intraoperative |
| Mean arterial pressure |
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Inclusion Criteria:
Exclusion Criteria:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Tanta University Hospitals | Tanta | El-Gharbia Governorate, Egypt | 31527 | Egypt |
The data will be available upon a reasonable request from the corresponding author after the end of study for one year.
After the end of study for one year.
The data will be available upon a reasonable request from the corresponding author.
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| Thoracic paravertebral block | Other | Patients will receive thoracic paravertebral block |
|
Mean arterial pressure will be recorded preoperative, before performing of block, and every 15 min till the end of surgery. |
| Till the end of surgery |
| Heart rate | Heart rate will be recorded preoperative, before performing of block, and every 15 min till the end of surgery. | Till the end of surgery |
| Time to the 1st rescue analgesia | All patients will receive paracetamol 1 gm every 6 h as routine analgesia. Rescue analgesia of morphine will be given as 2 mg bolus if the numeric rating scale > 3 to be repeated after 30 min if pain persists until the numeric rating scale < 4. NRS will be assessed at 0, 4, 8, 12, 18 and 24h postoperatively | 24 hours postoperatively |
| Degree of pain | Degree of pain will be measured using numeric rating scale (NRS) (0 represents "no pain" while 10 represents "the worst pain imaginable").NRS will be assessed at 0, 4, 8, 12, 18 and 24h postoperatively. | 24 hours postoperatively |
| Complications | Complications such as bradycardia, hypotension, nausea, vomiting, respiratory depression, local anesthetic systemic toxicity (LAST) or any other complication will be recorded. | 24 hour postoperatively |