Different Positions on the Diffusion and Blockade Effect of Ultrasound-guided Erector Spinae Plane Block

NCT ID: NCT06142630

Last Updated: 2025-02-10

Basic Information

• Recruitment Status: COMPLETED
• Clinical Phase: NA
• Total Enrollment: 84 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2023-11-21
• Study Completion Date: 2024-12-01

Brief Summary

After the completion of erector spinae plane block, the patient maintains different positions to assess the diffusion of local anesthetic and the effect of the block.

Detailed Description

Eighty-four patients were selected to undergo CT guided puncture localization of pulmonary nodules under local anesthesia, and the patients were divided into groups using a computer-generated random number in a ratio of 1:1:1. To ensure objectivity, a nurse who was not involved in the study prepared a sealed opaque envelope containing grouping information. Randomly divide patients into three groups: supine position group (S group, 28 patients), prone position group (P group, 28 patients), and lateral position group (L group, 28 patients). The patients underwent ultrasound guided ESPB on the puncture side before CT puncture localization. Ultrasound guided ESPB method: Using an ultrasound high-frequency linear array probe (5-13MHz, Sonosite, USA), the probe is placed parallel to the spine on the surface of the transverse process tip of the seventh thoracic vertebrae. Under ultrasound, the transverse process and spinal muscles are clearly exposed. Then, a short inclined plane puncture needle is used, and the needle is inserted from the head side using in-plane technology. After the needle tip reaches between the transverse process and erector spinae muscles, 1ml of physiological saline is injected using water separation technology to confirm the position of the needle tip, Then inject 30ml of local anesthetic solution (0.75% ropivacaine 15ml+iohexol 15ml). After the block was completed, patients in Group S remained in a supine position; Patients in group L maintained the blocking side above; Patients in Group P maintained a prone position. After 30 minutes of block completion, CT scan and puncture localization were performed, following with 3D reconstruction. The primary outcome was LA-contrast spread to the paravertebral space.The second outcomes were as follow: 1. spread to the neural foramina 2. cranio-caudal spread 3. spread to the epidural space 4. spread to the intercostal space.

Conditions

Erector Spinea Plane Block

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: PARALLEL
• Primary Study Purpose: PREVENTION
• Blinding Strategy: DOUBLE

Study Groups

Supine group

Patients remained supine

Group Type: NO_INTERVENTION

No interventions assigned to this group

Prone group

Patient remained prone

Group Type: EXPERIMENTAL

No interventions assigned to this group

Lateral position group

Patient remained in a lateral position

Group Type: EXPERIMENTAL

Alteration of patients' position after erector spinae plane block

Intervention Type: OTHER

After the erector spinae plane block was completed, the patients kept supine, lateral or prone position according to the group allocated for 30 minute to ensure the spread of local anesthetic

Interventions

Alteration of patients' position after erector spinae plane block

After the erector spinae plane block was completed, the patients kept supine, lateral or prone position according to the group allocated for 30 minute to ensure the spread of local anesthetic

Intervention Type: OTHER

Eligibility Criteria

Inclusion Criteria

Patients received CT guided puncture localization of pulmonary nodules under local anesthesia

Exclusion Criteria

1. Allergic to local anesthetic

2. History of opioid abuse

3. Severe skin infection

4. Peripheral neuropathy

5. Dysfunction of blood coagulation

• Minimum Eligible Age: 18 Years
• Maximum Eligible Age: 80 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: Yes

Sponsors

Nanjing First Hospital, Nanjing Medical University

OTHER

Sponsor Role: lead

Responsible Party

Responsibility Role: SPONSOR

Principal Investigators

Gu Jianping

Role: STUDY_CHAIR

Nanjing First Hospital, Nanjing Medical University

Locations

Nanjing First Hospital

Nanjing, Nanjing, China

Countries

China

References

Forero M, Adhikary SD, Lopez H, Tsui C, Chin KJ. The Erector Spinae Plane Block: A Novel Analgesic Technique in Thoracic Neuropathic Pain. Reg Anesth Pain Med. 2016 Sep-Oct;41(5):621-7. doi: 10.1097/AAP.0000000000000451.

Reference Type: BACKGROUND

PMID: 27501016 (View on PubMed)

Munoz F, Cubillos J, Bonilla AJ, Chin KJ. Erector spinae plane block for postoperative analgesia in pediatric oncological thoracic surgery. Can J Anaesth. 2017 Aug;64(8):880-882. doi: 10.1007/s12630-017-0894-0. Epub 2017 Apr 26. No abstract available.

Reference Type: BACKGROUND

PMID: 28447318 (View on PubMed)

Ueshima H, Otake H. RETRACTED: Erector spinae plane block provides effective pain management during pneumothorax surgery. J Clin Anesth. 2017 Aug;40:74. doi: 10.1016/j.jclinane.2017.04.016. Epub 2017 Apr 28. No abstract available.

Reference Type: BACKGROUND

PMID: 28625453 (View on PubMed)

Shan T, Zhang X, Zhao Z, Zhou X, Bao H, Su C, Tan Q, Han L, Yin J. Spread of local anaesthetic after erector spinae plane block: a randomised, three-dimensional reconstruction, imaging study. Br J Anaesth. 2025 Mar;134(3):830-838. doi: 10.1016/j.bja.2024.10.046. Epub 2025 Jan 8.

Reference Type: DERIVED

PMID: 39788818 (View on PubMed)

Other Identifiers

KY20230915-04

Identifier Type: -

Identifier Source: org_study_id