Pectoralis and Serratus Nerves Block in Thoracic Surgery

Surgery Clinical Trial

Official title:

Ultrasound Guided PECs II (Pectoralis and Serratus Nerves) Block in Patients Undergoing a Thoracic Surgery

Clinical Trial Details — Status: Not yet recruiting

Administrative data

• NCT number: NCT03023982
• Other study ID #: SOR 34516 CTIL
• Status: Not yet recruiting
• Phase: Phase 2
• First received: January 3, 2017
• Last updated: January 17, 2017
• Start date: February 2017
• Est. completion date: February 2019

Study information

• Verified date: January 2017
• Source: Soroka University Medical Center
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

A new conceptual regional anesthesia the PECs II block (modified pectoral and serratus nerves block) has been described for pain control after thoracic surgery, one of the indications to perform this method is analgesia for surgeries or procedures involving lateral chest wall

Description:

The PECs I block was found to be very effective after breast cancer surgery and sub-pectoral prosthesis for pain control management.

This block is provided by injection into another myofascial plane, this time between pectoralis minor and serratus anterior muscle at the level of 3rd and 4th rib.PECs II block is simple in performance with a high success rate and minimal incidence of complications, especially, if used ultrasound approach that gives a good understanding of anatomy of the lateral thoracic wall.

In present clinical trial we are going to compare PECs block for pain control with traditional pain management techniques based on IV opioids and NSAIDs treatment in patient undergoing thoracic surgery in early postoperative period.

Recruitment information / eligibility

• Status: Not yet recruiting
• Enrollment: 168
• Est. completion date: February 2019
• Est. primary completion date: February 2019
• Accepts healthy volunteers: No
• Gender: All
• Age group: 18 Years and older

Eligibility

Inclusion Criteria:

1. All patients undergoing thoracic surgery, older =18 years

2. Patients who meet criteria of ASA I-II-III class.

Exclusion Criteria:

1. Patients who will be unconscious or mentally incompetent

2. Patients refusal to participate in the study

3. ASA -IV -V

4. Patient with coagulopathy

5. Hemodynamically unstable (systolic BP < 90, HR > 100)

6. Allergy to local anesthetic drugs or opioids

7. Pregnant patient

8. History of opioid abuse

Related Conditions & MeSH terms

• Anesthesia
• Block
• Surgery
• Thoracic Injuries
• Thoracic Injury

Intervention

Drug:
• Bupivacaine Hydrochloride
40 cc 0.25% of Bupivacaine Hydrochloride injection using ultrasound approach will be administered between pectoralis minor and serratus anterior muscle at the 3rd and 4th rib

Device:
• Ultrasound
All blocks will be done under ultrasound

Procedure:
• Thoracotomy
The patient population will include patients that undergo either open thoracotomy or thoracoscopy for anatomic and non-anatomic lung resection. The standard thoracoscopy approach in our institute includes three holes technic. There are two incisions of 1 cm and utility incision of 4 cm. The standard thoracotomy is posterior- lateral thoracotomy which divided the latissimus dorsi muscle but spears the serratus anterior muscle.

Drug:
• Opioids
standard pain control with opioids
• NSAID
standard pain control with NSAIDs

Locations

Country	Name	City	State
n/a

Sponsors (1)

Lead Sponsor	Collaborator
Soroka University Medical Center

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Comparison Visual Analog Score between groups	First VAS after admission in PACU	First 24 hours from the surgery
Secondary	Total NSAIDs dosage (mg) in the PACU and department	While the patient is in PACU	First 24 hours from the surgery
Secondary	Length of hospital stay	Measuring time of at discharge from hospital	up to 21 days
Secondary	Total morphine dosage (mg) in the PACU and department	While the patient is in PACU	First 24 hours from the surgery