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This study aims to compare the ultrasound-guided edge of laminar block (ELB) and erector spinae plane block (ESPB) for postoperative analgesia in patients undergoing video-assisted thoracic surgery (VATS).
Postoperative pain after thoracic surgery, which is attributed to muscle incisions, rib retractions, and intercostal nerve damage, may be severe enough to cause pulmonary complications, such as atelectasis, pneumonia, and increased oxygen consumption.
The erector spinae plane block (ESPB) is used for managing post-thoracotomy pain and has numerous advantages that make it an attractive alternative technique. The ESPB injects a local anaesthetic around the erector spinae muscle at approximately the level of the T5. It may be able to block the dorsal and ventral rami of the thoracic spinal nerves.
A novel technique of retrolaminar block (RLB) called the edge of laminar block (ELB) to provide sensory analgesia during rib fracture surgery.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| ELB group | Experimental | Patients will receive edge of laminar block using 20ml of bupivacaine 0.25%. |
|
| ESPB group | Experimental | Patients will receive an erector spinae plane block using 20ml of bupivacaine 0.25%. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Edge of laminar block | Other | Patients will receive edge of laminar block using 20ml of bupivacaine 0.25%. |
|
| Measure | Description | Time Frame |
|---|---|---|
| Total morphine consumption | Rescue analgesia of morphine will be given as 3 mg bolus if the numeric rating scale (NRS)> 3 to be repeated after 30 min if pain persists until the NRS < 4. | 24 hours postoperatively |
| Measure | Description | Time Frame |
|---|---|---|
| Time to the 1st rescue analgesia | Time to the first request for the rescue analgesia (time from the end of surgery to first dose of morphine administrated). | 24 hours postoperatively |
| Intraoperative fentanyl consumption |
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Inclusion Criteria:
Exclusion Criteria:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Tanta University | Tanta | El-Gharbia | 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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| Erector spinae plane block | Other | Patients will receive an erector spinae plane block using 20ml of bupivacaine 0.25%. |
|
Additional fentanyl bolus dosages of 0.5 µg/kg IV will be administered if heart rate or mean arterial blood pressure elevated more than 20% of the baseline.
| Intraoperatively |
| Heart rate | Heart rate will be recorded preoperatively, before performing of block, and every 15 min till the end of surgery. | Till the end of surgery (Up to 2 hours) |
| Mean arterial pressure | Mean arterial pressure will be recorded preoperatively, before performing of block, and every 15 min till the end of surgery. | Till the end of surgery (Up to 2 hours) |
| Degree of pain | Each patient will be instructed about postoperative pain assessment with the numeric rating scale (NRS). NRS (0 represents "no pain" while 10 represents "the worst pain imaginable"). NRS will be assessed at post-anesthesia care unit (PACU), 2, 4, 6, 8, 12, 18, and 24 h postoperatively. | 24 hours postoperatively |
| Incidence of adverse events | Incidence of adverse events such as bradycardia, hypotension, nausea, vomiting, respiratory depression, pruritus, urinary retention, itching, constipation, or any other complication. | 24 hours postoperatively |