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Thoracotomy: Intercostal Nerve Block Versus Epidural Anesthesia

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details. Identifier: NCT01076894
Recruitment Status : Completed
First Posted : February 26, 2010
Last Update Posted : February 26, 2010
Information provided by:
University of Ulm

Brief Summary:

Postoperative pain and consecutive reduction of pulmonary function after thoracic surgery still is a major clinical problem and challenge in anesthesia. Thoracic epidural anesthesia is commonly considered to be the "gold standard" for postoperative pain control and restoration of pulmonary function after thoracic surgery.

Thus, the aim of the present study is to investigate whether an intercostal nerve block with ropivacaine plus intravenous PCA with morphine is as effective as thoracic epidural anesthesia with respect to postoperative pain control and pulmonary

Condition or disease Intervention/treatment Phase
Thoracotomy Procedure: epidural anesthesia Procedure: intercostal anesthesia Not Applicable

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Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 83 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: Analgesia and Pulmonary Function After Thoracic Surgery: is an Intercostal Nerve Block Plus Intravenous Morphine as Effective as Epidural Anesthesia? A Prospective Randomized Clinical Study.
Study Start Date : February 2007
Actual Primary Completion Date : October 2008
Actual Study Completion Date : October 2009

Arm Intervention/treatment
Active Comparator: epidural anesthesia Procedure: epidural anesthesia
In the epidural group prior to the induction of general anesthesia, a thoracic epidural catheter will be was placed at the level of the TH6-TH8. 8 ml ropivacaine 1% were administered through the epidural catheter. EDA is aimed at a sensory block level from TH2 to TH10.

Active Comparator: intercostal anesthesia Procedure: intercostal anesthesia
In the intercostal group, before chest closure, each 4 ml ropivacaine 0.75 % will be injected by the surgeon under direct vision into the proximal intercostal space at the level of the thoracotomy and two spaces above and below as well as 5 ml ropivacaine 0,75 % at the thoracic drainage tube exits

Primary Outcome Measures :
  1. Pain at rest and on coughing after thoracic surgery [ Time Frame: Pain during the first four postoperative days ]

Secondary Outcome Measures :
  1. pulmonary function (peak expiratory flow rate) after thoracic surgery [ Time Frame: first four postoperative days ]

Information from the National Library of Medicine

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Ages Eligible for Study:   18 Years and older   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  • patients undergoing elective pulmonary surgery, including pneumonectomy, bilobectomy, lobectomy, typical and atypical segmentectomy, via a lateral or posterolateral thoracotomy without chest-wall resection

Exclusion Criteria:

  • age<18 yr
  • any contraindication to epidural anaesthesia, intercostal nerve block or the use of ropivacaine, morphine, metamizol or diclofenac
  • lack of patient's cooperation
  • any type of chronic painful condition or current opioid use

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its identifier (NCT number): NCT01076894

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Universtity Clinic Ulm
Ulm, Germany, 89075
Sponsors and Collaborators
University of Ulm
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Study Chair: Michael Georgieff, Prof. Department for Anesthesiology University Clinic Ulm
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Responsible Party: Department of Anesthesiology, University Clinic Ulm Identifier: NCT01076894    
Other Study ID Numbers: EDA-ICB 198/06
First Posted: February 26, 2010    Key Record Dates
Last Update Posted: February 26, 2010
Last Verified: February 2010
Keywords provided by University of Ulm:
pulmonary function
epidural anesthesia
intercostal nerve block
Additional relevant MeSH terms:
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Central Nervous System Depressants
Physiological Effects of Drugs