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Comparison Effects of Three Regional Anesthetic Technique on Pain During Video-assisted Thorascopic Surgery(VATS)

NCT ID: NCT06689449

Last Updated: 2024-12-16

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

ACTIVE_NOT_RECRUITING

Total Enrollment

90 participants

Study Classification

OBSERVATIONAL

Study Start Date

2024-11-20

Study Completion Date

2026-10-20

Brief Summary

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In this study, our iş to compare effect of erector spinae plan block(ESP), paravertebral block(PVB) and mid-point transverse process to pleura block(MTP) on perioperative pain measured with analgesia nociceptive index monitor on video-assisted thoracoscopic surgery.

Detailed Description

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Video-assisted thoracoscopic surgery (VATS) is a minimally invasive thoracic surgery procedure performed with the help of a retractor-free camera through small skin incisions used to diagnose and treat chest diseases. Many of the major procedures traditionally performed with open thoracoscopic surgery can be performed using smaller sections with video assistance.

Thanks to the advances in minimally invasive techniques, the non-intubated thoracoscopic approach has been adapted even for use with major lung resections.

An adequate analgesia obtained from regional anaesthesia techniques allows VATS to be performed in sedated patients and the potential adverse effects related to general anaesthesia and selective ventilation can be avoided. The non-intubated procedures try to minimize the adverse effects of tracheal intubation and general anaesthesia, such as intubation-related airway trauma, ventilation-induced lung injury, residual neuromuscular blockade, and postoperative nausea and vomiting.

Local anaesthetic techniques essential for nonentubeted video assisted thoracic surgery include thoracic epidural anaesthesia, cervical epidural anaesthesia, paravertebral block, intercostal nerve block, injection of local anaesthetic at the site of trocar incision local vagus blockade, erector spinae plane block, serratus anterior plane block and pectoralis nerve block.

Thoracic epidural analgesia, once considered the gold standard for thoracotomy; due to the risks of complications related to dural puncture, epidural hematoma, neuropathy and hypotension, it is no longer the first choice for VATS and has been replaced by peripheral blocks.

ANI is a monitor that can be measured continuously and non-invasively. It measures parasympathetic tone - based on electrocardiography - by analyzing minimal changes in heart rate that occur under anesthesia, in the early stages of awakening, and in each respiratory cycle of awake patients. At the end of the measurement, a value between 0-100 is obtained.

Parasympathetic modulation (stress level, e.g., pain) is obtained with a minimum value of 0 and a maximum of 100. ANI values measured in the early period of recovery correlate with pain scores. When compared with hemodynamic parameters, it has been reported that the ANI response is more sensitive to nociceptive stimuli occurring in the intraoperative period.

In the high-risk patient group who will undergoing video-assisted thoracoscopic surgery (VATS) in the Faculty of Medicine of Erciyes University, the pain sensation in patients will be evaluated using ANI in the perioperative period, after the peripheral nerve blocks have been applied to different anatomical areas that are routinely used.

The aim of this study is to objectively reveal the perioperative pain after peripheral block applications in the patient group with serious additional morbidities by using the ANI device. It is expected that this study will enable more effective analgesia control in patients.

Conditions

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Video Assisted Thoracic Surgery (VATS)

Keywords

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video assisted thoracic surgery erector spinae plan block paravertebral block mid-point transverse process to pleura block analgesia nosiseption index

Study Design

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Observational Model Type

OTHER

Study Time Perspective

PROSPECTIVE

Study Groups

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erector spinae plan block group

The patient will be monitored with routine monitoring and ANI under operating room conditions. VAS values and vital signs before and after peripheral nerve block will be recorded. Patients will be placed in the lateral position and an erector spinae plane block will be applied under USG guidance by an experienced anesthesiologist. Surgery will be allowed 30 minutes after the block is performed.

No interventions assigned to this group

paravertebral block group

The patient will be monitored with routine monitoring and ANI under operating room conditions. VAS values and vital signs before and after peripheral nerve block will be recorded. Patients will be placed in the lateral position and a paravertebral block will be applied under USG guidance by an experienced anesthesiologist. Surgery will be allowed 30 minutes after the block is performed.

No interventions assigned to this group

mid-point transverse process to pleura block group

The patient will be monitored with routine monitoring and ANI under operating room conditions. VAS values and vital signsbefore and after peripheral nerve block will be recorded. Patients will be placed in the lateral position and a mid-point transverse process to pleura block will be applied under USG guidance by an experienced anesthesiologist. Surgery will be allowed 30 minutes after the block is performed.

No interventions assigned to this group

Eligibility Criteria

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Inclusion Criteria

* Patient over the age of 18 under the 80 Who will undergo video assisted thoracic surgery -ASA group 2-3-4.
* Patients without opioid addiction.
* Patients without allergies.
* Patients without psychiatric disorder.
* Patients without arrhymia and beta-blocker use.
* Patients without contraindications for peripheral blocks.

Exclusion Criteria

* Patients under age of 18
* Patients undergo surgery under general anesthesia
* Patients undergo emergency surgery
* Patients allergic to local anesthesia
* Patients wit bleeding diathesis
Minimum Eligible Age

18 Years

Maximum Eligible Age

80 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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TC Erciyes University

OTHER

Sponsor Role lead

Responsible Party

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Recep Aksu

clinical Professor.Recep AKSU

Responsibility Role PRINCIPAL_INVESTIGATOR

Locations

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Recep aksu

Kayseri, Kayseri̇, Turkey (Türkiye)

Site Status

Countries

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Turkey (Türkiye)

Other Identifiers

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2024/165

Identifier Type: -

Identifier Source: org_study_id