Neoplasms

Respiratory Tract (Lung and Bronchial) Diseases

All Conditions

Lung Neoplasms

Central Nervous System Depressants

All Drugs and Chemicals

Pharmaceutical Solutions

Bupivacaine

Anesthetics

Anesthetics, Local

Patients randomized to the group will receive a total 20cc of solution consisting of 0.5% bupivacaine with 133mg of liposomal bupivacaine injected in the serratus plane with the help of an ultrasound.

Patients randomized to the group will receive a total 20cc of 133mg liposomal bupivacaine injected prior to skin closure at the incision site as per surgeon's practice.

Bupivacaine liposome

Yan Lai, MD, MPH

Robotic video-assisted thoracoscopic surgery (VATS) is increasingly being used as it is a less invasive surgery compared to traditional methods, but the acute pain at an early stage after VATS has a major impact on perioperative outcomes. Effective post operative analgesia is believed to reduce morbidity, quicken recovery, improve patient outcome and reduce hospital costs. The site and extent of the incision influences the degree of pain due to disruption of intercostal nerves as well as inflammation of chest wall and pleura. Neuraxial and systemic opioids have been a gold standard as a part of multimodal analgesia for thoracic surgeries. Numerous modalities have been studied: thoracic paravertebral nerve blocks, thoracic epidural analgesia, intercostal nerve blocks, patient controlled analgesia (PCA), cryo-analgesia, transcutaneous electrical nerve stimulation (TENS), inter-pleural blocks, stellate ganglion blocks, long thoracic nerve blocks, and infiltration under direct vision by the surgeon.

Serratus plane block is an emerging regional technique that has proven to be effective in comparison to paravertebral blocks in patients undergoing breast surgery and mastectomy with reduced perioperative opioid consumption and improved pain scores.

The lateral pectoral nerve, medial pectoral nerve, intercostal nerves and long thoracic nerve are all targets for the serratus plane block. It can be safely performed under ultrasound guidance.

The purpose of the study is to evaluate the difference in quality of analgesia between efficacy of serratus plane block and local surgical infiltration by surgeon as measured by patient opioid consumption and pain scores.

Participants will be assigned randomly using a computer-generated table of numbers to either serratus group or infiltration group. Block team will perform all blocks.

The patient, surgeon, and anesthesiologist in the case will be blinded.

Efficacy Between Serratus Plane Block And Local Infiltration In Vats

Comparison Between Serratus Plane Block And Local Surgical Infiltration In Robotic Video Assisted Thoracoscopic Surgery- A Randomised Controlled Trial

The amount of opioid consumption (in mg IV morphine equivalents) postoperatively up to 24 hours after the procedure.

Time to first dose of narcotic administration post procedure

The length of stay post procedure in the PACU

The length of stay post procedure in the or ICU

Visual Analogue Score (VAS) pain score from 0 (no pain) to 10 (most pain)

Patient satisfaction score from 0 (not satisfied) to 10 (extremely satisfied)

Icahn School of Medicine at Mount Sinai

Assistant Professor

Serratus Plane Group

Placebo Group

Total

Age, Continuous

Sex: Female, Male

Asian

Black or African American

Hispanic or Latino

White

Race/Ethnicity, Customized

Poonam Pai

Amount of Opioid Consumption

Time to First Dose of Narcotic Administration

PACU Length of Stay

only those participants who required an ICU stay

ICU Length of Stay

baseline

at 2 hours

at 6 hours

at 18 hours

at 24 hours

Visual Analogue Score (VAS)

Patient Satisfaction Score

Overall Study

Symptoms and General Pathology

Nervous System Diseases

Pain, Postoperative

Pain

Infratentorial Neoplasms

Postoperative Complications

Neurologic Manifestations

Brain Neoplasms

Central Nervous System Neoplasms

Nervous System Neoplasms

Brain Diseases

Central Nervous System Diseases

Analgesics

Morphine

Analgesics, Opioid

Narcotics

In this arm, after general anesthesia, before surgery and head pin placement, scalp block will be applied. Scalp block will be performed with bupivacaine (Marcaine 5 mg/mL, 0,5% bupivacaine); nervus supraorbitalis, nervus supratrochlearis, n. auriculotemporalis, nervus zygomaticotemporalis, nervus occipitalis majoris and minoris will be bilaterally blocked with 2-3 ml bupivacaine.

In this arm, after general anesthesia, before surgery, 20 ml 0,5% bupivacaine (Marcaine 5 mg/ml, 0,5% bupivacaine) will be infiltrated to head pin points and skin incision area.

In this arm, neither scalp block, nor local infiltration will be performed.

In the scalp block and local infiltration arms; bupivacaine %0,5 will be used.

End of the surgery all of the patients in 3 groups will receive morphine patient controlled analgesia (PCA) including 1mg/ml morphine. The PCA was set to administer a bolus dose of 1 mg on demand with a lockout period of 10 minutes and maximum 25 mg for 4 hours.

morphine patient controlled analgesia

Yusuf Tunali, Professor

This study evaluate the effects of scalp block versus local infiltration on haemodynamic response to head pin replacement and skin incision and postoperative analgesia in posterior fossa surgery

In this study 15 patients will receive scalp block with bupivacaine, 15 patients will receive local infiltration with bupivacaine and 15 patients will receive placebo before surgery. The haemodynamic response to head pin replacement and skin incision will be recorded. Postoperatively all patients will have a patient controlled analgesia (PCA) device containing morphine (1 mg/ml) for analgesia. Visual analogue scale (VAS) for pain evaluation, sedation scores, and also postoperative morphine consumption will be evaluated and recorded.

The Effects of Scalp Block on Haemodynamic Response and Postoperative Pain in Posterior Fossa Surgery

The Effects of Scalp Block on Haemodynamic Response and Postoperative Pain in

heart rates (beats per minute) will be recorded before induction, before block, before head pinning, head pinning, head pin 5. and 10. minutes, skin incision

Systolic arterial pressures (mmHg) will be recorded in before induction, before block, before head pinning, head pinning, head pin 5. and 10. minutes, skin incision

Diastolic arterial pressures (mmHg) will be recorded before induction, before block, before head pinning, head pinning, head pin 5. and 10. minutes, skin incision

Mean arterial pressures (mmHg) will be recorded in will be recorded before induction, before block, before head pinning, head pinning, head pin 5. and 10. minutes, skin incision

pain scores (visual analogue score=VAS) will be evaluated.

morphine dosage used (mg) will be recorded in this time periods

Study title	NCT ID	Conditions	Interventions	Eligibility	Organization
Efficacy Between Serratus Plane Block And Local Infiltration In Vats	NCT03642457	Lung Cancer	Bupivacaine Bupivacaine lip...	18 Years - 75 Years	Icahn School of Medicine at Mount Sinai
The Effects of Scalp Block on Haemodynamic Response and Postoperative Pain in Posterior Fossa Surgery	NCT02852382	Posterior Fossa...	Bupivacaine morphine patien...	16 Years - 70 Years	Istanbul University
Efficacy Between Serratus Plane Block And Local Infiltration In Vats	NCT03642457	Lung Cancer	Bupivacaine Bupivacaine lip...	18 Years - 75 Years	Icahn School of Medicine at Mount Sinai

Spots Global Cancer Trial Database for local infiltration