The Impact of Ultrasound-Guided Superficial and Deep Paravertebral Nerve Blocks at the Superior Costotransverse Ligament on Hemodynamics During the Induction Phase of Thoracoscopic Lung Lobectomy: A Multicenter, Double-Blind, Randomized Controlled Trial

Launched by NANJING FIRST HOSPITAL, NANJING MEDICAL UNIVERSITY · Feb 21, 2025

Keywords

ClinConnect Summary

This clinical trial is studying the effects of two different methods of a nerve block, which is a way to numb a specific area of the body, on patients undergoing lung surgery. The researchers want to find out if a nerve block that does not penetrate a specific ligament is better at keeping blood pressure stable during the start of anesthesia compared to one that does penetrate the ligament. A total of 168 participants from five hospitals will be involved in this study. They need to be adults scheduled for a specific type of lung surgery, and they should not have certain health issues, like severe high blood pressure or heart problems.

Participants will receive one of the two nerve block methods about 30 minutes before their surgery. The researchers will monitor their vital signs, like heart rate and blood pressure, throughout the procedure to see which method works better. They will also check for any side effects or complications. After surgery, the participants will be asked about their pain levels and satisfaction with the procedure. This trial aims to improve patient care during lung surgeries by understanding how these nerve blocks affect patients' stability and comfort.

Gender

ALL

Eligibility criteria

• Inclusion Criteria:
• • Patients scheduled for elective two-port video-assisted thoracoscopic lobectomy
• • Age: ≥18 years
• • ASA classification: I-III
• • BMI: 18-30 kg/m²
• Exclusion Criteria:
• • Severe hypertension (SBP ≥180 mmHg or DBP ≥110 mmHg)
• • MAP \<70 mmHg before anesthesia induction
• • Emergency surgery
• • Severe cardiovascular disease, including history of cerebral or thoracic/abdominal aortic aneurysm
• • Congestive heart failure (New York Heart Association class III or IV)
• • Untreated or unstable ischemic heart disease
• • Severe aortic or mitral valve disease
• • Pregnancy or lactation
• • Coagulation disorders
• • Bacteremia, sepsis, or infection at the puncture site
• • Allergy to study-related drugs
• • Severe liver and kidney dysfunction
• • Neurological disorders, spinal disease (deformity or trauma), history of spinal surgery, or abnormal skin sensation in the thoracic or back region
• • Existing or anticipated difficult airway management
• • Other conditions deemed unsuitable for inclusion by the investigators Forty patients who required CT (3D) imaging technology to observe drug diffusion after the implementation of the two methods were included as follows: patients who were scheduled to undergo double-hole thoracoscopic lobectomy, aged ≥18 years, ASA grade I to III, BMI 18 to 30kg/m2, and required preoperative CT localization. Exclusion criteria In addition to the above conditions, patients with a history of anaphylaxis induced by contrast agents should be excluded.