Tramadol Hydrochnoride as Adjuvant to Local Anesthetic in Ultrasound Guided Erector Spinea Plane Block in Management of Chronic Chest Wall Cancer Pain

  • STATUS
    Recruiting
  • End date
    Mar 30, 2022
  • participants needed
    30
  • sponsor
    Assiut University
Updated on 28 November 2020

Summary

Chest wall pain is a severe and distressing symptom. The erector spinae plane block (ESPB) is an interfascial plane block where local anesthetic is injected between the erector spine muscle and the transverse process. It is a simple procedure, with easy sonographic landmarks, for postoperative analgesia in patients undergoing thoracic, abdominal, lumbar, and urologic surgery. The ESPB was initially described to relieve chronic pain from metastatic disease and rib fractures.

Description

Chest wall pain is a severe and distressing symptom.Interventional pain management aims to use invasive techniques such as joint injections, nerve blocks and/or neurolysis, neuromodulation, and cement augmentation techniques to diagnose and treat pain syndromes unresponsive to conventional medical management. The erector spinae plane block (ESPB) is an interfascial plane block where local anesthetic (LA) is injected between the erector spine muscle and the transverse process. It is a simple procedure, with easy sonographic landmarks, for postoperative analgesia in patients undergoing thoracic, abdominal, lumbar, and urologic surgery. The ESPB was initially described to relieve chronic pain from metastatic disease and rib fractures.

The ESPB provides blockade of ventral and dorsal ramus from T1-2 to T8-12 with easy insertion of a catheter into the distension induced by the injectate. It is performed away from the pleura and neuraxis, with low risk of complications in these structures.To our knowledge it is the first time study to evaluate the effectiveness of tramadol hydrochloride as adjuvant to local anaesthetic in ultrasound guided ESPB in the management of chronic chest wall cancer pain. Our hypothesis is that tramadol, when added to the local anaesthetic solution injected for ESPB, may improve analgesia and decrease the opioid consumption in patients with chronic chest wall cancer pain

Details
Treatment Erector spinea plane block, Erector spinea plane block
Clinical Study IdentifierNCT04639154
SponsorAssiut University
Last Modified on28 November 2020

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Eligibility

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Inclusion Criteria

Is your age between 18 yrs and 70 yrs?
Gender: Male or Female
Do you have any of these conditions: Post-Surgical Pain or Pain (Pediatric) or Pain or Chronic Pain or chronic pains or Erector Spinea Plane Block?
Do you have any of these conditions: chronic pains or Erector Spinea Plane Block or Chronic Pain or Pain (Pediatric) or Post-Surgical Pain or Pain?
patients with persistent chronic chest wall cancer pain (>6 months) with VAS pain score 5 on 0 to 10 scale despite of medical treatment with tramodine up to 200 mg daily

Exclusion Criteria

they have hypersensitivity to any of the studied drugs
obesity (BMI >35)
presence of local pathology such as recurrent cancer or infection at the site of injection
abnormal coagulation profile
an abnormal liver or renal function
unable to express their pain or
patient refusal
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