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Study protocol
Renee van den Broek
Catharina Ziekenhuis
Corresponding Author
ORCiD: https://orcid.org/0000-0001-5939-695X
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background: Thoracic epidural analgesia is considered the gold standard for pain relief in video-assisted thoracoscopic surgery. This neuraxial technique blocks pain sensation by injecting local anesthetic in the epidural space near the spinal cord to block spinal nerve roots. Recently, the erector spinae plane block has been introduced as a practical alternative to the thoracic epidural. This interfascial regional anesthesia technique interrupts pain sensation by injecting local anesthetic in between the muscular layers of the thoracic wall. Several case series and three RCTs described it as an effective pain management technique in video-assisted thoracoscopic surgery. (1–5)
The objective of this study is to test the hypothesis that a continuous erector spinae plane block is non-inferior in terms of the quality of recovery as measured by the Quality of Recovery-15 score compared to continuous thoracic epidural analgesia in patients undergoing elective unilateral video-assisted thoracoscopic surgery.
Methods: This is a prospective randomized open label non-inferiority trial. A total of 90 adult patients undergoing video-assisted thoracoscopic surgery will be randomized 1:1 to receive either pain treatment with continuous erector spinae plane block (study group) or continuous thoracic epidural analgesia (control group). The primary endpoint is the quality of recovery as measured by the Quality of Recovery-15 score. Secondary endpoints are postoperative pain as Numerical Rating Score scores, length of hospital stay, failure of analgesic technique, postoperative morphine-equivalent consumption, itching, nausea and vomiting, total operative time, complications related to surgery, perioperative hypotension, complications related to pain treatment, duration of bladder catheterization, time of first assisted mobilization >20 meters and of mobilization to sitting in a chair.
Discussion: This randomized controlled trial aims to confirm whether a continuous erector spinae plane block can equal analgesic effect as regional anesthesia technique compared with a thoracic epidural in patients undergoing video-assisted thoracoscopic surgery.
Keywords
Erector spinae plane block, thoracic epidural analgesia, regional anesthesia, postoperative pain, video-assisted thoracoscopic surgery, pain management.
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CURRENT STATUS: Under Review
Version 1
Posted 02 Feb, 2021
No community comments so far
Review #3 received
Received 30 Mar, 2021
Editorial decision: Minor revision
On 30 Mar, 2021
Review #2 received
Received 25 Mar, 2021
Reviewer #3 agreed
On 22 Mar, 2021
Reviewer #2 agreed
On 20 Mar, 2021
Reviewer #1 agreed
On 29 Jan, 2021
Review #1 received
Received 29 Jan, 2021
Reviewers invited
Invitations sent on 28 Jan, 2021
Editor assigned
On 19 Jan, 2021
Submission checks complete
On 19 Jan, 2021
Version (no preprint)
Posted 26 Nov, 2020
Reviewers invited
Invitations sent on 26 Nov, 2020
Editor assigned
On 28 Oct, 2020
Submission checks complete
On 24 Sep, 2020
First submitted
On 18 Jun, 2020
This version was not preprinted
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Subject Areas
Cardiothoracic Surgery
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This preprint is under consideration at Trials. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Study protocol
Renee van den Broek
Catharina Ziekenhuis
Corresponding Author
ORCiD: https://orcid.org/0000-0001-5939-695X
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Under Review
Version 1
Posted 02 Feb, 2021
No community comments so far
Review #3 received
Received 30 Mar, 2021
Editorial decision: Minor revision
On 30 Mar, 2021
Review #2 received
Received 25 Mar, 2021
Reviewer #3 agreed
On 22 Mar, 2021
Reviewer #2 agreed
On 20 Mar, 2021
Reviewer #1 agreed
On 29 Jan, 2021
Review #1 received
Received 29 Jan, 2021
Reviewers invited
Invitations sent on 28 Jan, 2021
Editor assigned
On 19 Jan, 2021
Submission checks complete
On 19 Jan, 2021
Version (no preprint)
Posted 26 Nov, 2020
Reviewers invited
Invitations sent on 26 Nov, 2020
Editor assigned
On 28 Oct, 2020
Submission checks complete
On 24 Sep, 2020
First submitted
On 18 Jun, 2020
This version was not preprinted
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Cardiothoracic Surgery
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background: Thoracic epidural analgesia is considered the gold standard for pain relief in video-assisted thoracoscopic surgery. This neuraxial technique blocks pain sensation by injecting local anesthetic in the epidural space near the spinal cord to block spinal nerve roots. Recently, the erector spinae plane block has been introduced as a practical alternative to the thoracic epidural. This interfascial regional anesthesia technique interrupts pain sensation by injecting local anesthetic in between the muscular layers of the thoracic wall. Several case series and three RCTs described it as an effective pain management technique in video-assisted thoracoscopic surgery. (1–5)
The objective of this study is to test the hypothesis that a continuous erector spinae plane block is non-inferior in terms of the quality of recovery as measured by the Quality of Recovery-15 score compared to continuous thoracic epidural analgesia in patients undergoing elective unilateral video-assisted thoracoscopic surgery.
Methods: This is a prospective randomized open label non-inferiority trial. A total of 90 adult patients undergoing video-assisted thoracoscopic surgery will be randomized 1:1 to receive either pain treatment with continuous erector spinae plane block (study group) or continuous thoracic epidural analgesia (control group). The primary endpoint is the quality of recovery as measured by the Quality of Recovery-15 score. Secondary endpoints are postoperative pain as Numerical Rating Score scores, length of hospital stay, failure of analgesic technique, postoperative morphine-equivalent consumption, itching, nausea and vomiting, total operative time, complications related to surgery, perioperative hypotension, complications related to pain treatment, duration of bladder catheterization, time of first assisted mobilization >20 meters and of mobilization to sitting in a chair.
Discussion: This randomized controlled trial aims to confirm whether a continuous erector spinae plane block can equal analgesic effect as regional anesthesia technique compared with a thoracic epidural in patients undergoing video-assisted thoracoscopic surgery.
Figure 1
Figure 2
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