Pain, Postoperative Clinical Trial
Official title:
Prospective, Randomised, Single-Blinded, Monocentric Clinical Study to Compare Postoperative Analgesia and Outcome After Combined Paravertebral and Intrathecal Versus Thoracic Epidural Analgesia for Thoracotomy
The purpose of this study is to compare whether epidural analgesia would provide equal analgesia than combining intrathecal opioids with thoracic paravertebral local anesthetics.
Thoracotomy is an invasive surgical procedure, which is mainly performed in patients with
pre-existing lung disease such as lung cancer or chronic obstructive pulmonary disease. Pain
after thoracotomy is considered the most intense acute postoperative pain, adversely
affecting the ability to cough, deep breathing, and lung function, resulting in respiratory
complications and delayed recovery. The adverse effects can be further aggravated by
occurrence of chronic post-thoracotomy pain.
Thoracic epidural analgesia is often recommended as the gold standard for the relief of
acute post-thoracotomy pain. Thoracic paravertebral blockade or intrathecal opioid analgesia
has also been shown to be efficacious for pain relief. Since there is no ideal single
regional technique for pain relief after thoracotomy an alternative method maybe the
combination of low-dose intrathecal morphine and sufentanil plus continuous thoracic
paravertebral analgesia with local anesthetics.
We therefore hypothesized that combining intrathecal sufentanil and morphine with thoracic
paravertebral applicated ropivacaine would provide equal analgesia compared to thoracic
epidural analgesia with ropivacaine and sufentanil. We further speculate that this new
regimen would have a lower incidence of typical side effects due to TEA, such as block
failure, hypotension or urinary retention.
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Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Single Blind, Primary Purpose: Treatment
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