New Truncal Nerve Blocks for Thoracoscopic Surgery and Open Heart Surgery.

NCT ID: NCT03704753

Last Updated: 2023-02-23

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Clinical Phase

PHASE4

Total Enrollment

200 participants

Study Classification

INTERVENTIONAL

Study Start Date

2019-01-25

Study Completion Date

2025-05-31

Brief Summary

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This study is divided to two sub-studies. First sub-study evaluates if Serratus Anterior Plane block (SAPB) reduces opioid consumption after thoracoscopic surgery. Secondly continuous SAPB is compared to continuous intercostal blockade. Second sub-study evaluates if Subpectoral Interfascial Plane block (SIP) reduces opioid consumption after medial sternotomy.

Detailed Description

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Serratus anterior plane block (SAPB) - sub-study

In this sub-study 120 patients will be randomly assigned to one of four groups:

SAPB group A 30ml of Ropivacaine 7,5mg/ml is injected above m. serratus anterior after thoracoscopic lung surgery. Injection is done under ultrasound guidance.

SAPB group B 30ml of Sodiumchloride 0.9 is injected above m. serratus anterior after thoracoscopic lung surgery. Injection is done under ultrasound guidance.

SAPB group C 30ml of Ropivacaine 7,5mg/m is injected above m. serratus anterior after thoracoscopic lung surgery. Also a multi-holed catheter is left in place. Through catheter 20ml Ropivacaine 2mg/ml is injected every 12 hours after surgery.

SAPB group D A multi-holed catheter is placed in single intercostal space under thoracoscopic visualization. 20ml of Ropivacaine 7,5mg/ml is injected after application of the catheter, also a continuous infusion of ropivacaine 2mg/ml is started. Rate of the infusion is determined by patients weight.

Subpectoral Interfascial Plane block (SIP) - sub-study

In this sub-study 80 patients will be randomly assigned to one of two groups:

SIP group A 20ml of ropivacaine 7,5mg/ml is injected under both pectoralis major muscles before medial sternotomy. Injection is done under ultrasound guidance.

SIP group B 20ml of sodiumchloride 0.9 is injected under both pectoralis major muscles before medial sternotomy. Injection is done under ultrasound guidance.

Every patients postoperative pain is treated with intravenous oxycodone PCA-pump.

The investigators will evaluate post operative pain based on the Numeric rating Scale, 24 hours oxycodone consumption. The investigators will also evaluate post operative chronic pain using three questionnaires: EQ5D, STAIT-TRAIT and Pain Detect. In SAPB sub-study the questionnaires are done three weeks and 6 months post. operatively. In SIP sub-study the questionnaires are done 6 months and 12 months post.operatively.

Conditions

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Postoperative Pain

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Randomised and double blinded.
Primary Study Purpose

TREATMENT

Blinding Strategy

QUADRUPLE

Participants Caregivers Investigators Outcome Assessors

Study Groups

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SAPB group A

SAPB single injection. 30ml of Ropivacaine 7,5mg/ml is injected above m. serratus anterior after thoracoscopic lung surgery. Infection is done under ultrasound guidance.

Group Type ACTIVE_COMPARATOR

Ropivacaine

Intervention Type DRUG

Serratus anterior plane block for thoracic surgery patients and subpectoral interfascial nerve block for open heart surgery patients

SAPB group B

SAPB single injection (placebo). 30ml of SodiumChloride 0.9 is injected above m. serratus anterior after thoracoscopic lung surgery. Infection is done under ultrasound guidance.

Group Type PLACEBO_COMPARATOR

Sodium chloride 0.9%

Intervention Type DRUG

Serratus anterior plane block for thoracic surgery patients and subpectoral interfascial nerve block for open heart surgery patients (placebo).

SAPB group C

SAPB single injection and catheter. 30ml of Ropivacaine 7,5mg/ml is injected above m. serratus anterior after thoracoscopic lung surgery and a multi-holed catheter is left in place. 20ml of Ropivacaine 2mg/ml is injected every 12h through catheter postoperatively.

Group Type ACTIVE_COMPARATOR

Ropivacaine

Intervention Type DRUG

Serratus anterior plane block for thoracic surgery patients and subpectoral interfascial nerve block for open heart surgery patients

SAPB group D

Continious intercostal catheter. 20ml of Ropivacaine 7,5mg/ml is injected through intercostal catheter, which i placed under thoracoscopic visualization. After single injection a continuous infusion of Ropivacaine 2mg/ml is started (weight dependent daily dosage).

Group Type ACTIVE_COMPARATOR

Ropivacaine

Intervention Type DRUG

Serratus anterior plane block for thoracic surgery patients and subpectoral interfascial nerve block for open heart surgery patients

SIP group A

SIP single injection 20ml of Ropivacaine 7,5mg/ml is injected under pectoralis major muscle on both sides of sternum. Injection is done under ultrasound guidance.

Group Type ACTIVE_COMPARATOR

Ropivacaine

Intervention Type DRUG

Serratus anterior plane block for thoracic surgery patients and subpectoral interfascial nerve block for open heart surgery patients

SIP group B

SIP single injection (placebo) 20ml of SodiumChloride 0.9 is injected under pectoralis major muscle on both sides of sternum. Injection is done under ultrasound guidance.

Group Type PLACEBO_COMPARATOR

Sodium chloride 0.9%

Intervention Type DRUG

Serratus anterior plane block for thoracic surgery patients and subpectoral interfascial nerve block for open heart surgery patients (placebo).

Interventions

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Ropivacaine

Serratus anterior plane block for thoracic surgery patients and subpectoral interfascial nerve block for open heart surgery patients

Intervention Type DRUG

Sodium chloride 0.9%

Serratus anterior plane block for thoracic surgery patients and subpectoral interfascial nerve block for open heart surgery patients (placebo).

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

* Elective thoracoscopic lung surgery or elective open heart valve surgery

Exclusion Criteria

* DM1 with complications, lack of co-operation, refusal, chronic pain, chronic intake of opioids or use of SNRI or tricyclic antidepressants.
Minimum Eligible Age

18 Years

Maximum Eligible Age

85 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Tampere University Hospital

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Locations

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Tampere Heart Hospital

Tampere, , Finland

Site Status RECRUITING

Countries

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Finland

Central Contacts

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Antti J Kalli, MD

Role: CONTACT

0500723498 ext. +358

Kati M Järvelä, MD, PhD

Role: CONTACT

31164869 ext. +3583

Facility Contacts

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Timo Porkkala, Phd

Role: primary

03311664887 ext. +358

References

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Kalli A, Vistbacka J, Moilanen E, Jarvela K, Mennander A. Superficial Parasternal Intercostal Plane Block and Full Sternotomy; A Randomized Trial. Eur J Cardiothorac Surg. 2025 Jul 1;67(7):ezaf226. doi: 10.1093/ejcts/ezaf226.

Reference Type DERIVED
PMID: 40627369 (View on PubMed)

Other Identifiers

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R18011M

Identifier Type: -

Identifier Source: org_study_id

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