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ITPB 1 vs 3 in VATS

ConditionMusculoskeletal Diseases or Conditions
Trial statusRecruiting
Trial phaseNot applicable
Trial typeInterventional
Biological sexAll
Age18-80
SponsorChinese University of Hong Kong

About this trial

This study aims to evaluate the quality of recovery after video-assisted thoracoscopic surgery (VATS) by comparing the efficacy of a single-level intertransverse process block (ITPB) against a three-level ITPB, with particular attention to the quality of recovery measured by the QoR15 score at 24 hours post-surgery.

Eligibility criteria

This trial does not accept healthy volunteers

Qualifiers

ASA I-III patients

18 to 80 years of age

Patients with primary carcinoma lung scheduled for resection under VATS procedure

Disqualifiers

Patient refusal

Local skin infection at the area of injection

Coagulopathy

History of allergy to local anaesthetics

Trial design

Design model

Parallel

Treatments tested in this trial

  • Single Level Intertransverse Process Block

    Procedure/Surgery

    Patients will then be positioned in the lateral decubitus position with the side to be blocked facing upwards, the neck slightly flexed and the upper arm resting on the pillow for the USG ITPB. The thoracic intervertebral levels (T3, T5, T7) will be identified and marked on the patient. Ultrasound gel will be applied to the skin foracoustic coupling and the transducer is placed 2-3 cm lateral to the spinous process, at the target vertebral level, in the t After obtaining the target transverse ultrasound window at the articular process level, under strict aseptic precautions and local infiltration (Lignocaine 1%), a SonoTap nerve block needle (Pajunk, 22G, 80 mm, Pajunk, Geisingen, Germany) will be inserted in-plane and slowly advanced from a lateral to medial direction until its tip is located at the medial aspect of the retro-SCTL space. After negative heme aspiration, 25 ml of LA mixture containing 0.5% ropivacaine with 1: 200,000 adrenaline will be injected slowly in small aliquots.

  • Three Level Intertransverse Process Block

    Procedure/Surgery

    Patients will then be positioned in the lateral decubitus position with the side to be blocked facing upwards, the neck slightly flexed and the upper arm resting on the pillow for the USG ITPB. After obtaining the target transverse ultrasound window at the inferior articular process level (described above) at the T7 level, under strict aseptic precautions and local infiltration (Lignocaine 1%), a SonoTap nerve block needle (Pajunk, 22G, 80 mm, Pajunk, Geisingen, Germany) will be inserted in-plane and slowly advanced from a lateral to medial direction until its tip is located at the medial aspect of the retro-SCTL space. After negative heme aspiration, 8 ml of LA mixture containing 0.5% ropivacaine with 1:200,000 adrenaline will be injected slowly in small aliquots. Subsequently, similar injections will be performed at T5 and T3 level with 8 ml and 9 ml LA mixture, respectively (Total LA mixture volume: 25 ml).

Treatment groups

80 Participants
are divided into 2 treatment groups
Group A: Single Level Intertransverse Process BlockActive comparator 1 intervention
Group B: Three Level Intertransverse Process BlockActive comparator 1 intervention

Trial outcomes

Primary outcomes

1

Quality of recovery

Comparing the quality of recovery 15 (QoR15) score at 24 hours between the study groups. QoR15: a minimum score of 0 (poor recovery) and a maximum score of 150 (excellent recovery)

Time frame
At 24 hours post surgery

Secondary outcomes

1

Area under the curve for pain at rest and movement (deep breathing)

Comparing the area under the curve (AUC) of postoperative pain numerical rating score (NRS, 0-10) at rest and deep breathing (pain burden).

Time frame
Over the first 24 hours after surgery
2

Number of hypoesthetic and anaesthetic dermatomes

Number of anaesthetic and hypoesthetic dermatomes on the ventral and dorsal aspect of the thorax

Time frame
At 15 and 30 minutes after block completion
3

Rescue fentanyl and phenylephrine administration

Total rescue fentanyl and phenylephrine administration

Time frame
Intraoperative
4

Postoperative morphine, tramadol and ondansetron consumption

Total postoperative morphine, tramadol and ondansetron consumption

Time frame
At 24 and 48 hour post sugery

Other outcomes

Sponsors and contacts

Click on the lead sponsor to view all of their trials.

Chinese University of Hong Kong

Lead sponsor

Source ClinicalTrials.gov
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