Ignite Creation Date:
2024-10-26 @ 3:38 PM
Last Modification Date:
2024-10-26 @ 3:38 PM
Study NCT ID:
NCT06562634
Status:
NOT_YET_RECRUITING
Last Update Posted:
None
First Post:
2024-08-14
Brief Title:
Effectiveness of Ultrasound-Guided Erector Spinae Plane Block for Postoperative Pain Control in Open Knee Surgeries
Sponsor:
None
Organization:
None
Study Overview
Official Title:
Effectiveness of Ultrasound-Guided Erector Spinae Plane Block for Postoperative Pain Control in Open Knee Surgeries
Status:
NOT_YET_RECRUITING
Status Verified Date:
2024-08
Last Known Status:
None
Delayed Posting:
No
If Stopped, Why?:
Not Stopped
Has Expanded Access:
No
If Expanded Access, NCT#:
N/A
Has Expanded Access, NCT# Status:
N/A
Acronym:
None
Brief Summary:
To estimate the efficacy of the ultrasound guided ESP block for postoperative pain control in open knee surgeries under general anesthesia
Detailed Description:
Postoperative pain is a major concern after knee surgeries It is severe in 60 of patients and moderate in 30 When inadequately treated it intensifies reflex responses which leads to cause serious complications such as cardiovascular pulmonary or urinary problems thromboembolism increased oxygen consumption hyperdynamic circulation and hinders early physical therapy Generally it has been assumed that adequate postoperative pain relief may reduce these complications and improve general postoperative outcome
In the last decade Improvements in pain management techniques have had a major impact on the practice of knee surgeries Although there are a number of treatment options for postoperative pain a gold standard has not been established Patient-controlled analgesia PCA epidural analgesia and lumbar plexus andor sciatic blocks are the commonly used routes for pain relief after joint surgery Each of those options has advantages and disadvantages PCA has fewer technical problems uniform and sustained analgesia with autonomy however it might lead to respiratory depression nausea and vomiting Epidural analgesia is an efficient route for postoperative analgesia however it is associated with technical failures hypotension urinary retention and ileus motor block that limits ambulation unrecognized compartment syndromes and spinal hematoma secondary to anticoagulation
The ultrasound-guided erector spinae plane ESP block is a recently described regional anesthetic technique for providing thoracic analgesia when performed at the level of T5 transverse process Local anesthetic is injected into the fascial plane deep to the erector spinae muscle and spreads craniocaudally over several levels can lead to effective analgesia and sensory block from T2 to T9 Local anesthetic also penetrates anteriorly through the intertransverse connective tissue and enters the thoracic paravertebral space where it can potentially block not only the ventral and dorsal rami of spinal nerves but also the rami communicantes that transmit sympathetic fibers
ESP advantages include its simplicity easy identifiable ultrasonographic landmarks and an endpoint for injection and low risk for serious complications as injection is into tissue plane that is distant from pleura major blood vessels and discrete nerves
There is clinical report of two cases shows the ESP block may be a safe simple and effective technique for analgesia following surgery around the knee
However confirmation of the efficacy of ESP block in knee surgeries needs more investigation
In the last decade Improvements in pain management techniques have had a major impact on the practice of knee surgeries Although there are a number of treatment options for postoperative pain a gold standard has not been established Patient-controlled analgesia PCA epidural analgesia and lumbar plexus andor sciatic blocks are the commonly used routes for pain relief after joint surgery Each of those options has advantages and disadvantages PCA has fewer technical problems uniform and sustained analgesia with autonomy however it might lead to respiratory depression nausea and vomiting Epidural analgesia is an efficient route for postoperative analgesia however it is associated with technical failures hypotension urinary retention and ileus motor block that limits ambulation unrecognized compartment syndromes and spinal hematoma secondary to anticoagulation
The ultrasound-guided erector spinae plane ESP block is a recently described regional anesthetic technique for providing thoracic analgesia when performed at the level of T5 transverse process Local anesthetic is injected into the fascial plane deep to the erector spinae muscle and spreads craniocaudally over several levels can lead to effective analgesia and sensory block from T2 to T9 Local anesthetic also penetrates anteriorly through the intertransverse connective tissue and enters the thoracic paravertebral space where it can potentially block not only the ventral and dorsal rami of spinal nerves but also the rami communicantes that transmit sympathetic fibers
ESP advantages include its simplicity easy identifiable ultrasonographic landmarks and an endpoint for injection and low risk for serious complications as injection is into tissue plane that is distant from pleura major blood vessels and discrete nerves
There is clinical report of two cases shows the ESP block may be a safe simple and effective technique for analgesia following surgery around the knee
However confirmation of the efficacy of ESP block in knee surgeries needs more investigation
Study Oversight
Has Oversight DMC:
None
Is a FDA Regulated Drug?:
None
Is a FDA Regulated Device?:
None
Is an Unapproved Device?:
None
Is a PPSD?:
None
Is a US Export?:
None
Is an FDA AA801 Violation?:
None