Erector Spinae Plane Block Versus Intercostal for VATS
Lung Cancer, Lung Diseases
About this trial
This is an interventional treatment trial for Lung Cancer
Eligibility Criteria
Inclusion Criteria:
- Male and female patients
- age between 18 to 80 years old
- ASA 1-3
- scheduled for VATS
- informed consent explained and signed
Exclusion Criteria:
- Patients < 18 years old, > 80 years old
- ASA physical status > 3
- morbid obesity (BMI >40)
- previous cardiac surgery or ipsilateral thoracic surgery
- neuropsychiatric diseases
- serum albumin < 35 g/L
- cardiac, renal (creatinine > 200mmol/l) or hepatic failure (aspartate amino transferase, alanine amino transferase > 50 % over the normal range)
- anemia (hematocrit <30%)
- organ transplant
- allergy to analgesics or local anesthetics or other medications used in the study
- abuse of opioids or sedatives
- contraindication to receive regional anesthesia (e.g. coagulation defect)
- patients who could not understand the VAS pain-scoring system
- patient refusal to follow participation
- intraoperative conversion to open thoracotomy
- revision or re-operation or complication of surgery during the follow-up time
- post operative mechanical ventilation
- intolerance or allergy to any prescribed medication
Sites / Locations
- Montreal General HospitalRecruiting
Arms of the Study
Arm 1
Arm 2
Experimental
Sham Comparator
ESP block
ESP sham block
patients will receive an ultrasound guided ESP block (technique as described by Forero et al) under strict sterile conditions in the operating room area. After identifying the T5 transverse process (TP) and after infiltration of lidocaine 2% subcutaneously. A 22g 100mm block needle will be advanced under vision, in a cephalad to caudad direction, until the tip contacts the T5 TP. 20 ml of 0.25% bupivacaine with 5 mcg/ml of epinephrine and 10 mg dexamethasone will be injected under the erector spinae muscle. A visible separation of the erector spinae muscle from the TP will be the sign of a successful block. A 20 ml syringe of Normal Saline will be given to the surgeon (unaware of the content) at the end of the surgery, for the intercostal nerve block as per standard present technique.
patients will receive an ultrasound guided sham ESP block under strict sterile conditions in the operating room area as described above. 20 ml of Normal Saline will be injected under the erector spinae muscle. A 20 ml syringe of 0.25% bupivacaine with 5 mcg/ml of epinephrine and 10 mg dexamethasone will be given to the surgeon (blinded to the content) at the end of the surgery for the intercostal nerve block.