Different Positions on the Diffusion and Blockade Effect of Ultrasound-guided Erector Spinae Plane Block
Study Details
Study Description
Brief Summary
After the completion of exploring the vertical erector spinae plane block, the patient maintains different positions to assess the diffusion of local anesthetic and the effect of the block.
| Condition or Disease | Intervention/Treatment | Phase |
|---|---|---|
|
N/A |
Detailed Description
Thirty patients were selected to undergo CT guided puncture localization of pulmonary nodules under local anesthesia, and the patients were divided into groups using a computer-generated random number in a ratio of 1:1:1. To ensure objectivity, a nurse who was not involved in the study prepared a sealed opaque envelope containing grouping information. Randomly divide patients into three groups: supine position group (S group, 10 cases), prone position group (P group, 10 cases), and lateral position group (L group, 10 cases). The patient underwent ultrasound guided ESPB on the puncture side before CT puncture localization. Ultrasound guided ESPB method: Using an ultrasound high-frequency linear array probe (5-13MHz, Sonosite, USA), the probe is placed parallel to the spine on the surface of the transverse process tip of the fifth thoracic vertebrae. Under ultrasound, the transverse process and surface vertical spinal muscles are clearly exposed. Then, a short inclined plane puncture needle is used, and the needle is inserted from the head side using in-plane technology. After the needle tip reaches below the transverse process plane vertical spinal muscles, 2ml of physiological saline is injected using water separation technology to confirm the position of the needle tip, Then inject 30ml of local anesthetic solution (0.375% ropivacaine 25ml+iohexol 5ml). After the block was completed, patients in Group S remained in a supine position; Patients in group L maintained the blocking side above; Patients in Group P maintained a prone position. After 1 hour of block completion, CT scan and puncture localization were performed, followed by 3D reconstruction. Observation and recording of local anesthetic solution: 1. Diffusion range towards the head and tail; 2-way diffusion range of rib gap on one side 3; Diffusion to the paravertebral space; 4. Diffusion into the epidural space.
Study Design
Arms and Interventions
| Arm | Intervention/Treatment |
|---|---|
| No Intervention: Supine group Patients remained supine |
|
| Experimental: Prone group Patient remained prone |
Other: Alteration of patients' position after erector spinae plane block
After the erector spinae plane block was completed, the patients kept lateral or prone position according to the group allocated for one hour to ensure the spread of local anesthetic
|
| Experimental: Lateral position group Patient remained in a lateral position |
Other: Alteration of patients' position after erector spinae plane block
After the erector spinae plane block was completed, the patients kept lateral or prone position according to the group allocated for one hour to ensure the spread of local anesthetic
|
Outcome Measures
Primary Outcome Measures
- Incidence and number of local anesthetic diffusion segment into the paravertebral space [1 hour after completion of the ESPB block]
Observation of local anesthetic spread spread into the paravertebral space with CT by a researcher who was blinded to group allocation
Secondary Outcome Measures
- Diffusion of local anesthetic into intercostal space [1 hour after completion of the block]
The diffusion of local anesthetics to intercostal space was observed with CT by a researcher who was blinded to group allocation
- Diffusion of local anesthetic into the epidural space [1 hour after completion of the block]
Incidence and segment of local anesthetic spread into the epidural was assessed by a researcher who was blinded to group allocation
- Sensory loss of cold [30 min and 60 min immediately after completion of the nerve block]
The extent of sensory loss was assessed with cold stimulation, including the anterior chest wall (midclavicular line), lateral chest wall (posterior axillary line), and posterior chest wall (paraspinal zone) by a researcher who was blinded to group allocation
Eligibility Criteria
Criteria
Inclusion Criteria:
Patients received CT guided puncture localization of pulmonary nodules under local anesthesia
Exclusion Criteria:
-
Allergic to local anesthetic
-
History of opioid abuse
-
Severe skin infection
-
Peripheral neuropathy
-
Dysfunction of blood coagulation
Contacts and Locations
Locations
| Site | City | State | Country | Postal Code | |
|---|---|---|---|---|---|
| 1 | Nanjing First Hospital | Nanjing | Nanjing | China | 210006 |
Sponsors and Collaborators
- Nanjing First Hospital, Nanjing Medical University
Investigators
- Study Chair: Gu Jianping, Nanjing First Hospital, Nanjing Medical University
Study Documents (Full-Text)
None provided.More Information
Publications
None provided.- KY20230915-04