Intrapleural Nebulization of Bupivacain to Reduce Postoperative Pain
Pain Managment After VATS to Reduce Postoperative Pain and Improve Pulmonary Function
Assiut University
60 participants
May 17, 2024
INTERVENTIONAL
Conditions
Summary
Thoracic surgery is now common and as other surgeries evolution of minimally invasive techniques is employed. Video-assisted thoracic surgery (VATS) produces little scar but may produce severe pain that may affect the pulmonary function. Many procedure was developed like intercostal nerve block which require injections at multiple levels, Insertion of local anaesthetic (LA) in the surgical drain but that was dangerous due to the large amount of LA and not sufficient to completely eliminate pain. Bupvicaine nebulization, through surgical port which won't make any other wound, thought to be sufficient because Nebulization will enable us better distribution and less amounts of LA. Bupvicaine is local anaesthetic amide group that works by blocking sodium channels thus preventing progression of action potential.
Eligibility
Inclusion Criteria2
- Patients that reach American socity of anesthesiologist class 1-3
- Scheduled for VATS surgery under general anesthesia.
Exclusion Criteria6
- ● Allergy to local anesthetics
- Patient with pleural inflammation due to recent pneumonia
- Patients who are unable or unwilling to perform spirometer test
- Renal dysfunction: (Elevated creatinine > 2 mg\\dl)
- Hepatic dysfunction: (Elevated hepatic enzymes three times above normal value)
- History of addiction
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Interventions
Intrapleural nebulization of bupivacine (10 ml of bupivacaine 0.5%) + Intravenous normal saline as a placebo
Intravenous analgesia: paracetamol (one gram) and Ketorolac (30 mg) + Intrapleural normal saline (10 ml) as a placebo
Locations(1)
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NCT05282251