Extrapleural Intercostal Catheter Vs. Thoracic Epidural for Thoracotomy Pain
Recruitment status was Recruiting
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Purpose
We will compare thoracic epidural anesthesia which is presently used for management of pain after thoracotomy to an intra-operatively placed extrapleural intercostal catheter. The study wil be double blinded and prospective.
| Condition | Intervention | Phase |
|---|---|---|
|
Thoracotomy |
Procedure: extrapleural intercostal catheter vs. thoracic epidural |
Phase 1 |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Efficacy Study Intervention Model: Parallel Assignment Masking: Double-Blind Primary Purpose: Health Services Research |
| Official Title: | A Prospective Randomized Trial Comparing Extrapleural Intercostal Local Anesthesia Versus Thoracic Epidural for the Managment of Acute Post Thoracotomy Pain |
- pain control-visual analog pain score
- respiratory measurements (FEV1, PEF), pain score, nausea and vomiting, opiod usage as adjunct to primary treatmetn modalities
| Estimated Enrollment: | 60 |
| Study Start Date: | September 2006 |
| Estimated Study Completion Date: | March 2008 |
The aim of this study is to evaluate the efficacy of thoracic epidural vs. continuous extra-pleural intercostal local anesthesia for the treatment of post thoracotomy pain in adult patients. Study patients will be randomized between the thoracic epidural and continuous extrapleural catheter groups[Figure 1]. Because thoracic epidural anesthesia is the gold standard but continuous extrapleural intercostal local anesthesia is potentially easier and less prone to complications, the study will be structured as an "equivalence study". The null hypothesis (Ho) is that continuous intercostal nerve blockade is worse than epidural for post-thoracotomy pain management. Therefore, the alternative hypothesis (Ha) is then that continuous intercostal nerve blockade is equal to or better than epidural for post-thoracotomy pain management.
Eligibility| Ages Eligible for Study: | 18 Years and older |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Unilateral thoracotomy
- Video Assisted thoracotomy with high likely hood of converting to open thoracotmoy
Exclusion Criteria:
- Bilateral thoracotomy
- Planned bilateral thoracotomy
- Planned chest wall resection
- Planned combined thoracotomy and laparotomy procedure
- VATS procedure without conversion to unilateral thoracotomy
- Emergency operation
- Critically ill patients
- Patients who require an assistive device (i.e. cane, walker, or wheel chair) for mobility
- Patients who are unable to give informed consent
- Patients with preoperative chronic back or chest wall pain
- Empyema or other infective condition increasing the risk of epidural infection
- Coagulopathy
- Decision of the surgeon or anesthesiologist, or choice of the patient
- Infection at site of epidural placement
- Patients with other co morbidities which exclude thoracic epidural placement
- Patients under the age of 18 years
Contacts and Locations| Contact: Mark Nelson, MD | 804-373-7987 | Mnelson3@vcu.edu |
| Contact: Darrin Letsinger, MD | 804-828-4999 ext 1646 | dletsinger@vcu.edu |
| United States, Virginia | |
| Virginia Commonwealth University | Recruiting |
| Richmond, Virginia, United States, 23298 | |
| Contact: Mark Nelson, MD 804-373-7987 Mnelson3@vcu.edu | |
| Contact: Jay Napoleon, MD 804-828-0733 | |
| Sub-Investigator: Darrin B Letsinger, MD, MS | |
| Sub-Investigator: Danielle Lindenmuth, MD | |
| Principal Investigator: | Mark Nelson, MD | Virgina Commonwealth University, Dept of Anesthesia |
More Information
No publications provided
| ClinicalTrials.gov Identifier: | NCT00373633 History of Changes |
| Other Study ID Numbers: | VCU 011906 |
| Study First Received: | September 6, 2006 |
| Last Updated: | September 7, 2006 |
| Health Authority: | United States: Institutional Review Board |
Keywords provided by Virginia Commonwealth University:
|
THoracic Surgery thoracic epidural epidural thoracotomy |
intercostal nerve block intercostal nerve block |
ClinicalTrials.gov processed this record on May 19, 2013