Pain Control After VATS Anatomical Pulmonary Resections
Lung Cancer, Pain, Postoperative, Thoracic Neoplasms
About this trial
This is an interventional treatment trial for Lung Cancer focused on measuring thoracoscopic surgery, post-operative pain, epidural anesthesia, ESP block, cryoanalgesia, lobectomy
Eligibility Criteria
Inclusion Criteria: all patients undergoing VATS anatomic pulmonary resection (lobectomy or segmentectomy) for benign or malignant disease Exclusion Criteria: Refusal or inability to give informed consent to the study protocol Age < 18 years Pregnancy Allergies or contraindications to any of the treatments considered in the experimental design Pre-operative use of pain medication for chronic pain or neuropathic pain History of previous major chest surgery American Society of Anesthesiologists (ASA) class > 3 Need for intensive care unit stay in the post-operative period Patients undergoing anatomical pulmonary resections different than lobectomy or segmentectomy (bi-lobectomy or pneumonectomy). Patients undergoing bronchial and/or vascular resections and reconstructions
Sites / Locations
- Thoracic Surgery UnitRecruiting
Arms of the Study
Arm 1
Arm 2
Arm 3
Experimental
Experimental
Experimental
Epidural
ESP block
Cryoanalgesia
In patients randomized to this Arm, before the induction of general anesthesia, the epidural catheter is placed in the intervertebral space (T4-T5, T5-6 or T6-T7) and used intra and post-operatively for administration of local anesthetics.
In patients randomized to this Arm, after induction of general anesthesia the Erector spinae plane (ESP) block is performed with a catheter introduced and left in place for continuous postoperative infusion of local anesthetics.
In patients randomized to this Arm, after induction of general anesthesia and single lung ventilation the first thoracoscopic surgical access is performed. A cryoanesthesia device with a dedicated atraumatic angled-tip cryoprobe is inserted through the thoracoscopic access and the active tip of the probe is positioned in contact with the intercostal nerves from T3 to T8.