xml: <clinical_study>
    <!-- This xml conforms to an XML Schema at:
      https://clinicaltrials.gov/ct2/html/images/info/public.xsd -->
    <required_header>
      <download_date>ClinicalTrials.gov processed this data on September 20, 2023</download_date>
      <link_text>Link to the current ClinicalTrials.gov record.</link_text>
      <url>https://clinicaltrials.gov/ct2/show/NCT05993273</url>
    </required_header>
    <id_info>
      <org_study_id>5697/AO/23</org_study_id>
      <nct_id>NCT05993273</nct_id>
    </id_info>
    <brief_title>Pain Control After VATS Anatomical Pulmonary Resections</brief_title>
    <official_title>Pain Control After VATS Anatomical Pulmonary Resections: Randomized Comparison Between Cryoanalgesia, Erector Spinae Plane Block and Epidural Catheter</official_title>
    <sponsors>
      <lead_sponsor>
        <agency>University Hospital Padova</agency>
        <agency_class>Other</agency_class>
      </lead_sponsor>
    </sponsors>
    <source>University Hospital Padova</source>
    <oversight_info>
      <is_fda_regulated_drug>No</is_fda_regulated_drug>
      <is_fda_regulated_device>No</is_fda_regulated_device>
    </oversight_info>
    <brief_summary>
      <textblock>
        In patients undergoing minimally invasive thoracoscopic surgery (video-assisted thoracoscopic&#xD;
        surgery, or VATS), moderate to severe post-operative pain may often be experienced. The&#xD;
        presence of pain negatively affects the perceived quality of care and can predispose to&#xD;
        complications, as the development of chronic pain.&#xD;
  &#xD;
        In order to prevent post-operative pain, different multimodal pain treatment protocols are&#xD;
        applied, consisting in combinations of local-regional anesthesiological techniques and&#xD;
        intravenous medications.&#xD;
  &#xD;
        Regional anesthesia is considered essential to prevent pain in the immediate post-operative&#xD;
        period. However, to date, there is no agreement regarding which is the most effective&#xD;
        regional anesthesiological technique; therefore, the choice is usually based on the&#xD;
        Anesthetist's preferences.&#xD;
  &#xD;
        The aim of this study is to compare three regional anesthesiological techniques&#xD;
        (cryoanalgesia, epidural anesthesia, and erector spinae muscle plane block) routinely used&#xD;
        during thoracoscopic lung surgery.&#xD;
      </textblock>
    </brief_summary>
    <detailed_description>
      <textblock>
        In patients undergoing minimally invasive thoracoscopic surgery (video-assisted thoracoscopic&#xD;
        surgery, or VATS), moderate to severe post-operative pain may often be experienced. The&#xD;
        presence of pain negatively affects the perceived quality of care and can predispose to&#xD;
        complications, as the development of chronic pain.&#xD;
  &#xD;
        In order to prevent post-operative pain, different multimodal pain treatment protocols are&#xD;
        applied, consisting in combinations of local-regional anesthesiological techniques and&#xD;
        intravenous medications.&#xD;
  &#xD;
        Regional anesthesia is considered essential to prevent pain in the immediate post-operative&#xD;
        period. However, to date, there is no agreement regarding which is the most effective&#xD;
        regional anesthesiological technique; therefore, the choice is usually based on the&#xD;
        Anesthetist's preferences.&#xD;
  &#xD;
        The aim of this study is to compare three regional anesthesiological techniques&#xD;
        (cryoanalgesia, epidural anesthesia, and erector spinae muscle plane block) routinely used&#xD;
        during thoracoscopic lung surgery.&#xD;
  &#xD;
        All patients undergoing anatomical pulmonary resections (lobectomy or segmentectomy) through&#xD;
        a thoracoscopic (VATS) approach, and who present the inclusion/exclusion characteristics,&#xD;
        will be considered.&#xD;
  &#xD;
        The day of surgery, patients are randomized 1:1:1 to receive 3 different pain control&#xD;
        techniques: epidural catheter, ESP block or cryoanalgesia.&#xD;
  &#xD;
        A standard pain management protocol will be applied to all patient after surgery.&#xD;
  &#xD;
        Primary Outcome Measure is the perceived post-operative pain 24 hours after surgery in the 3&#xD;
        groups, evaluated through numeric pain rating scale (NPRS). Other outcome measures are the&#xD;
        post-operative pain trend and the patients' total amount of opioid use in the postoperative&#xD;
        period (expressed as Morphine milligram equivalents).&#xD;
      </textblock>
    </detailed_description>
    <overall_status>Recruiting</overall_status>
    <start_date type="Actual">April 5, 2023</start_date>
    <completion_date type="Anticipated">April 15, 2024</completion_date>
    <primary_completion_date type="Anticipated">April 15, 2024</primary_completion_date>
    <phase>N/A</phase>
    <study_type>Interventional</study_type>
    <has_expanded_access>No</has_expanded_access>
    <study_design_info>
      <allocation>Randomized</allocation>
      <intervention_model>Parallel Assignment</intervention_model>
      <primary_purpose>Treatment</primary_purpose>
      <masking>None (Open Label)</masking>
    </study_design_info>
    <primary_outcome>
      <measure>Post-operative pain</measure>
      <time_frame>24 hours after surgery</time_frame>
      <description>Perceived post-operative pain 24 hours after surgery through Numeric Pain Rating Scale (NPRS, value from 0 to 10, o=no pain, 10=worst pain ever)</description>
    </primary_outcome>
    <secondary_outcome>
      <measure>Post-operative pain trend</measure>
      <time_frame>1,6,12 and 48 hours after surgery</time_frame>
      <description>Perceived post-operative pain 1,6,12 and 48 hours after surgery through Numeric Pain Rating Scale (NPRS, value from 0 to 10, o=no pain, 10=worst pain ever)</description>
    </secondary_outcome>
    <secondary_outcome>
      <measure>Rescue Analgesia</measure>
      <time_frame>48 hours after surgery</time_frame>
      <description>patients' total amount of opioid use in the postoperative period (expressed as Morphine milligram equivalents)</description>
    </secondary_outcome>
    <number_of_arms>3</number_of_arms>
    <enrollment type="Anticipated">75</enrollment>
    <condition>Lung Cancer</condition>
    <condition>Pain, Postoperative</condition>
    <condition>Thoracic Neoplasms</condition>
    <arm_group>
      <arm_group_label>Epidural</arm_group_label>
      <arm_group_type>Experimental</arm_group_type>
      <description>In patients randomized to this Arm, before the induction of general anesthesia, the epidural catheter is placed in the intervertebral space (T4-T5, T5-6 or T6-T7) and used intra and post-operatively for administration of local anesthetics.</description>
    </arm_group>
    <arm_group>
      <arm_group_label>ESP block</arm_group_label>
      <arm_group_type>Experimental</arm_group_type>
      <description>In patients randomized to this Arm, after induction of general anesthesia the Erector spinae plane (ESP) block is performed with a catheter introduced and left in place for continuous postoperative infusion of local anesthetics.</description>
    </arm_group>
    <arm_group>
      <arm_group_label>Cryoanalgesia</arm_group_label>
      <arm_group_type>Experimental</arm_group_type>
      <description>In patients randomized to this Arm, after induction of general anesthesia and single lung ventilation the first thoracoscopic surgical access is performed. A cryoanesthesia device with a dedicated atraumatic angled-tip cryoprobe is inserted through the thoracoscopic access and the active tip of the probe is positioned in contact with the intercostal nerves from T3 to T8.</description>
    </arm_group>
    <intervention>
      <intervention_type>Procedure</intervention_type>
      <intervention_name>Epidural</intervention_name>
      <description>The epidural catheter is placed while the patient is awake, before the induction of general anesthesia. The intervertebral spaces used for catheter insertion are alternatively T4-T5, T5-6 or T6-T7. After locating the epidural space through the technique of the loss of resistance, a catheter is introduced for about 5 cm and left in place for the administration of drugs into the epidural space. Once the correct functioning of the epidural catheter has been verified with a negative test for cerebrospinal fluid aspiration and a negative bolus test for the onset of signs and symptoms from intrathecal infusion, the catheter is used intraoperatively for administration of local anesthetics in refracted boluses (Lidocaine and Ropivacaine ) at anesthetic dosage and postoperatively for continuous infusion of Ropivacaine 0.15% at 5 mL/h.</description>
      <arm_group_label>Epidural</arm_group_label>
    </intervention>
    <intervention>
      <intervention_type>Procedure</intervention_type>
      <intervention_name>ESP block</intervention_name>
      <description>Erector spinae plane (ESP) block is performed after induction of general anesthesia, with the patient in a lateral decubitus position. With the aid of the ultrasound guide with linear probe, the transverse process of T5 ipsilateral to the site of the operation is identified. With the in-plane technique, the lower fascia of the ESP muscle is hydrodissected through the administration of Ropivacaine 0.5% 3 mg/Kg lean body weight. Subsequently, a catheter is introduced and left in place for continuous postoperative infusion of Ropivacaine 0.2% at 12 mL/h.</description>
      <arm_group_label>ESP block</arm_group_label>
    </intervention>
    <intervention>
      <intervention_type>Procedure</intervention_type>
      <intervention_name>Cryoanalgesia</intervention_name>
      <description>Cryoanalgesia is performed after the induction of general anesthesia, single lung ventilation and after performing the first thoracoscopic surgical access. A cryoanesthesia device with a dedicated atraumatic angled-tip cryoprobe is inserted through the thoracoscopic access. The active tip of the probe is positioned in contact with the intercostal nerves from T3 to T8 and kept resting for 4 ½ minutes on each nerve at a temperature of -70°C, under direct thoracoscopic vision, generating an interruption of the sensory functions.</description>
      <arm_group_label>Cryoanalgesia</arm_group_label>
    </intervention>
    <eligibility>
      <criteria>
        <textblock>
          Inclusion Criteria:&#xD;
  &#xD;
            -  all patients undergoing VATS anatomic pulmonary resection (lobectomy or segmentectomy)&#xD;
               for benign or malignant disease&#xD;
  &#xD;
          Exclusion Criteria:&#xD;
  &#xD;
            -  Refusal or inability to give informed consent to the study protocol&#xD;
  &#xD;
            -  Age &lt; 18 years&#xD;
  &#xD;
            -  Pregnancy&#xD;
  &#xD;
            -  Allergies or contraindications to any of the treatments considered in the experimental&#xD;
               design&#xD;
  &#xD;
            -  Pre-operative use of pain medication for chronic pain or neuropathic pain&#xD;
  &#xD;
            -  History of previous major chest surgery&#xD;
  &#xD;
            -  American Society of Anesthesiologists (ASA) class &gt; 3&#xD;
  &#xD;
            -  Need for intensive care unit stay in the post-operative period&#xD;
  &#xD;
            -  Patients undergoing anatomical pulmonary resections different than lobectomy or&#xD;
               segmentectomy (bi-lobectomy or pneumonectomy).&#xD;
  &#xD;
            -  Patients undergoing bronchial and/or vascular resections and reconstructions&#xD;
        </textblock>
      </criteria>
      <gender>All</gender>
      <minimum_age>18 Years</minimum_age>
      <maximum_age>N/A</maximum_age>
      <healthy_volunteers>No</healthy_volunteers>
    </eligibility>
    <overall_official>
      <last_name>MARCO MAMMANA, MD, PhD</last_name>
      <role>Principal Investigator</role>
      <affiliation>PADUA UNIVERSITY HOSPITAL</affiliation>
    </overall_official>
    <overall_contact>
      <last_name>MARCO MAMMANA, MD, PhD</last_name>
      <phone>+390498212442</phone>
      <email>marco.mammana@aopd.veneto.it</email>
    </overall_contact>
    <location>
      <facility>
        <name>Thoracic Surgery Unit</name>
        <address>
          <city>Padua</city>
          <zip>35128</zip>
          <country>Italy</country>
        </address>
      </facility>
      <status>Recruiting</status>
      <contact>
        <last_name>MARCO MAMMANA, MD,PhD</last_name>
        <phone>+390498212442</phone>
        <email>marco.mammana@aopd.veneto.it</email>
      </contact>
    </location>
    <location_countries>
      <country>Italy</country>
    </location_countries>
    <reference>
      <citation>Gurkan Y, Aksu C, Kus A, Yorukoglu UH, Kilic CT. Ultrasound guided erector spinae plane block reduces postoperative opioid consumption following breast surgery: A randomized controlled study. J Clin Anesth. 2018 Nov;50:65-68. doi: 10.1016/j.jclinane.2018.06.033. Epub 2018 Jul 2.</citation>
      <PMID>29980005</PMID>
    </reference>
    <reference>
      <citation>Tulgar S, Kapakli MS, Senturk O, Selvi O, Serifsoy TE, Ozer Z. Evaluation of ultrasound-guided erector spinae plane block for postoperative analgesia in laparoscopic cholecystectomy: A prospective, randomized, controlled clinical trial. J Clin Anesth. 2018 Sep;49:101-106. doi: 10.1016/j.jclinane.2018.06.019. Epub 2018 Jun 15.</citation>
      <PMID>29913392</PMID>
    </reference>
    <reference>
      <citation>Chin KJ, Adhikary S, Sarwani N, Forero M. The analgesic efficacy of pre-operative bilateral erector spinae plane (ESP) blocks in patients having ventral hernia repair. Anaesthesia. 2017 Apr;72(4):452-460. doi: 10.1111/anae.13814. Epub 2017 Feb 11.</citation>
      <PMID>28188621</PMID>
    </reference>
    <reference>
      <citation>Forero M, Adhikary SD, Lopez H, Tsui C, Chin KJ. The Erector Spinae Plane Block: A Novel Analgesic Technique in Thoracic Neuropathic Pain. Reg Anesth Pain Med. 2016 Sep-Oct;41(5):621-7. doi: 10.1097/AAP.0000000000000451.</citation>
      <PMID>27501016</PMID>
    </reference>
    <reference>
      <citation>Sepsas E, Misthos P, Anagnostopulu M, Toparlaki O, Voyagis G, Kakaris S. The role of intercostal cryoanalgesia in post-thoracotomy analgesia. Interact Cardiovasc Thorac Surg. 2013 Jun;16(6):814-8. doi: 10.1093/icvts/ivs516. Epub 2013 Feb 19.</citation>
      <PMID>23424242</PMID>
    </reference>
    <reference>
      <citation>Ju H, Feng Y, Yang BX, Wang J. Comparison of epidural analgesia and intercostal nerve cryoanalgesia for post-thoracotomy pain control. Eur J Pain. 2008 Apr;12(3):378-84. doi: 10.1016/j.ejpain.2007.07.011. Epub 2007 Sep 17.</citation>
      <PMID>17870625</PMID>
    </reference>
    <reference>
      <citation>Torre M, Mameli L, Bonfiglio R, Guerriero V, Derosas L, Palomba L, Disma N. A New Device for Thoracoscopic Cryoanalgesia in Pectus Excavatum Repair: Preliminary Single Center Experience. Front Pediatr. 2021 Jan 18;8:614097. doi: 10.3389/fped.2020.614097. eCollection 2020.</citation>
      <PMID>33585365</PMID>
    </reference>
    <reference>
      <citation>Lin J, Liao Y, Gong C, Yu L, Gao F, Yu J, Chen J, Chen X, Zheng T, Zheng X. Regional Analgesia in Video-Assisted Thoracic Surgery: A Bayesian Network Meta-Analysis. Front Med (Lausanne). 2022 Apr 6;9:842332. doi: 10.3389/fmed.2022.842332. eCollection 2022.</citation>
      <PMID>35463038</PMID>
    </reference>
    <reference>
      <citation>Fiorelli S, Leopizzi G, Menna C, Teodonio L, Ibrahim M, Rendina EA, Ricci A, De Blasi RA, Rocco M, Massullo D. Ultrasound-Guided Erector Spinae Plane Block Versus Intercostal Nerve Block for Post-Minithoracotomy Acute Pain Management: A Randomized Controlled Trial. J Cardiothorac Vasc Anesth. 2020 Sep;34(9):2421-2429. doi: 10.1053/j.jvca.2020.01.026. Epub 2020 Jan 21.</citation>
      <PMID>32144056</PMID>
    </reference>
    <reference>
      <citation>Taketa Y, Irisawa Y, Fujitani T. Comparison of ultrasound-guided erector spinae plane block and thoracic paravertebral block for postoperative analgesia after video-assisted thoracic surgery: a randomized controlled non-inferiority clinical trial. Reg Anesth Pain Med. 2019 Nov 8:rapm-2019-100827. doi: 10.1136/rapm-2019-100827. Online ahead of print.</citation>
      <PMID>31704789</PMID>
    </reference>
    <verification_date>August 2023</verification_date>
    <study_first_submitted>July 25, 2023</study_first_submitted>
    <study_first_submitted_qc>August 11, 2023</study_first_submitted_qc>
    <study_first_posted type="Actual">August 15, 2023</study_first_posted>
    <last_update_submitted>August 11, 2023</last_update_submitted>
    <last_update_submitted_qc>August 11, 2023</last_update_submitted_qc>
    <last_update_posted type="Actual">August 15, 2023</last_update_posted>
    <responsible_party>
      <responsible_party_type>Principal Investigator</responsible_party_type>
      <investigator_affiliation>University Hospital Padova</investigator_affiliation>
      <investigator_full_name>Giovanni Maria Comacchio</investigator_full_name>
      <investigator_title>Thoracic Surgeon</investigator_title>
    </responsible_party>
    <keyword>thoracoscopic surgery</keyword>
    <keyword>post-operative pain</keyword>
    <keyword>epidural anesthesia</keyword>
    <keyword>ESP block</keyword>
    <keyword>cryoanalgesia</keyword>
    <keyword>lobectomy</keyword>
    <condition_browse>
      <!-- CAUTION:  The following MeSH terms are assigned with an imperfect algorithm            -->
      <mesh_term>Thoracic Neoplasms</mesh_term>
      <mesh_term>Pain, Postoperative</mesh_term>
    </condition_browse>
    <patient_data>
      <sharing_ipd>No</sharing_ipd>
    </patient_data>
    <!-- Results have not yet been posted for this study                                          -->
  </clinical_study>
  
  
text: download date: ClinicalTrials.gov processed this data on September 20, 2023
  link text: Link to the current ClinicalTrials.gov record.
  url: https://clinicaltrials.gov/ct2/show/NCT05993273
  org study id: 5697/AO/23
  nct id: NCT05993273
  lead sponsor: 
  is fda regulated drug: No
  is fda regulated device: No
  In patients undergoing minimally invasive thoracoscopic surgery (video-assisted thoracoscopic
        surgery, or VATS), moderate to severe post-operative pain may often be experienced. The
        presence of pain negatively affects the perceived quality of care and can predispose to
        complications, as the development of chronic pain.
  
        In order to prevent post-operative pain, different multimodal pain treatment protocols are
        applied, consisting in combinations of local-regional anesthesiological techniques and
        intravenous medications.
  
        Regional anesthesia is considered essential to prevent pain in the immediate post-operative
        period. However, to date, there is no agreement regarding which is the most effective
        regional anesthesiological technique; therefore, the choice is usually based on the
        Anesthetist's preferences.
  
        The aim of this study is to compare three regional anesthesiological techniques
        (cryoanalgesia, epidural anesthesia, and erector spinae muscle plane block) routinely used
        during thoracoscopic lung surgery.
  In patients undergoing minimally invasive thoracoscopic surgery (video-assisted thoracoscopic
        surgery, or VATS), moderate to severe post-operative pain may often be experienced. The
        presence of pain negatively affects the perceived quality of care and can predispose to
        complications, as the development of chronic pain.
  
        In order to prevent post-operative pain, different multimodal pain treatment protocols are
        applied, consisting in combinations of local-regional anesthesiological techniques and
        intravenous medications.
  
        Regional anesthesia is considered essential to prevent pain in the immediate post-operative
        period. However, to date, there is no agreement regarding which is the most effective
        regional anesthesiological technique; therefore, the choice is usually based on the
        Anesthetist's preferences.
  
        The aim of this study is to compare three regional anesthesiological techniques
        (cryoanalgesia, epidural anesthesia, and erector spinae muscle plane block) routinely used
        during thoracoscopic lung surgery.
  
        All patients undergoing anatomical pulmonary resections (lobectomy or segmentectomy) through
        a thoracoscopic (VATS) approach, and who present the inclusion/exclusion characteristics,
        will be considered.
  
        The day of surgery, patients are randomized 1:1:1 to receive 3 different pain control
        techniques: epidural catheter, ESP block or cryoanalgesia.
  
        A standard pain management protocol will be applied to all patient after surgery.
  
        Primary Outcome Measure is the perceived post-operative pain 24 hours after surgery in the 3
        groups, evaluated through numeric pain rating scale (NPRS). Other outcome measures are the
        post-operative pain trend and the patients' total amount of opioid use in the postoperative
        period (expressed as Morphine milligram equivalents).
  allocation: Randomized
  intervention model: Parallel Assignment
  primary purpose: Treatment
  masking: None (Open Label)
  measure: Post-operative pain
  time frame: 24 hours after surgery
  description: Perceived post-operative pain 24 hours after surgery through Numeric Pain Rating Scale (NPRS, value from 0 to 10, o=no pain, 10=worst pain ever)
  measure: Post-operative pain trend
  time frame: 1,6,12 and 48 hours after surgery
  description: Perceived post-operative pain 1,6,12 and 48 hours after surgery through Numeric Pain Rating Scale (NPRS, value from 0 to 10, o=no pain, 10=worst pain ever)
  measure: Rescue Analgesia
  time frame: 48 hours after surgery
  description: patients' total amount of opioid use in the postoperative period (expressed as Morphine milligram equivalents)
  arm group label: Epidural
  arm group type: Experimental
  description: In patients randomized to this Arm, before the induction of general anesthesia, the epidural catheter is placed in the intervertebral space (T4-T5, T5-6 or T6-T7) and used intra and post-operatively for administration of local anesthetics.
  arm group label: ESP block
  arm group type: Experimental
  description: In patients randomized to this Arm, after induction of general anesthesia the Erector spinae plane (ESP) block is performed with a catheter introduced and left in place for continuous postoperative infusion of local anesthetics.
  arm group label: Cryoanalgesia
  arm group type: Experimental
  description: In patients randomized to this Arm, after induction of general anesthesia and single lung ventilation the first thoracoscopic surgical access is performed. A cryoanesthesia device with a dedicated atraumatic angled-tip cryoprobe is inserted through the thoracoscopic access and the active tip of the probe is positioned in contact with the intercostal nerves from T3 to T8.
  intervention type: Procedure
  intervention name: Epidural
  description: The epidural catheter is placed while the patient is awake, before the induction of general anesthesia. The intervertebral spaces used for catheter insertion are alternatively T4-T5, T5-6 or T6-T7. After locating the epidural space through the technique of the loss of resistance, a catheter is introduced for about 5 cm and left in place for the administration of drugs into the epidural space. Once the correct functioning of the epidural catheter has been verified with a negative test for cerebrospinal fluid aspiration and a negative bolus test for the onset of signs and symptoms from intrathecal infusion, the catheter is used intraoperatively for administration of local anesthetics in refracted boluses (Lidocaine and Ropivacaine ) at anesthetic dosage and postoperatively for continuous infusion of Ropivacaine 0.15% at 5 mL/h.
  arm group label: Epidural
  intervention type: Procedure
  intervention name: ESP block
  description: Erector spinae plane (ESP) block is performed after induction of general anesthesia, with the patient in a lateral decubitus position. With the aid of the ultrasound guide with linear probe, the transverse process of T5 ipsilateral to the site of the operation is identified. With the in-plane technique, the lower fascia of the ESP muscle is hydrodissected through the administration of Ropivacaine 0.5% 3 mg/Kg lean body weight. Subsequently, a catheter is introduced and left in place for continuous postoperative infusion of Ropivacaine 0.2% at 12 mL/h.
  arm group label: ESP block
  intervention type: Procedure
  intervention name: Cryoanalgesia
  description: Cryoanalgesia is performed after the induction of general anesthesia, single lung ventilation and after performing the first thoracoscopic surgical access. A cryoanesthesia device with a dedicated atraumatic angled-tip cryoprobe is inserted through the thoracoscopic access. The active tip of the probe is positioned in contact with the intercostal nerves from T3 to T8 and kept resting for 4 ½ minutes on each nerve at a temperature of -70°C, under direct thoracoscopic vision, generating an interruption of the sensory functions.
  arm group label: Cryoanalgesia
  criteria: 
  gender: All
  minimum age: 18 Years
  maximum age: N/A
  healthy volunteers: No
  last name: MARCO MAMMANA, MD, PhD
  role: Principal Investigator
  affiliation: PADUA UNIVERSITY HOSPITAL
  last name: MARCO MAMMANA, MD, PhD
  phone: +390498212442
  email: marco.mammana@aopd.veneto.it
  facility: 
  status: Recruiting
  contact: 
  country: Italy
  citation: Gurkan Y, Aksu C, Kus A, Yorukoglu UH, Kilic CT. Ultrasound guided erector spinae plane block reduces postoperative opioid consumption following breast surgery: A randomized controlled study. J Clin Anesth. 2018 Nov;50:65-68. doi: 10.1016/j.jclinane.2018.06.033. Epub 2018 Jul 2.
  PMID: 29980005
  citation: Tulgar S, Kapakli MS, Senturk O, Selvi O, Serifsoy TE, Ozer Z. Evaluation of ultrasound-guided erector spinae plane block for postoperative analgesia in laparoscopic cholecystectomy: A prospective, randomized, controlled clinical trial. J Clin Anesth. 2018 Sep;49:101-106. doi: 10.1016/j.jclinane.2018.06.019. Epub 2018 Jun 15.
  PMID: 29913392
  citation: Chin KJ, Adhikary S, Sarwani N, Forero M. The analgesic efficacy of pre-operative bilateral erector spinae plane (ESP) blocks in patients having ventral hernia repair. Anaesthesia. 2017 Apr;72(4):452-460. doi: 10.1111/anae.13814. Epub 2017 Feb 11.
  PMID: 28188621
  citation: Forero M, Adhikary SD, Lopez H, Tsui C, Chin KJ. The Erector Spinae Plane Block: A Novel Analgesic Technique in Thoracic Neuropathic Pain. Reg Anesth Pain Med. 2016 Sep-Oct;41(5):621-7. doi: 10.1097/AAP.0000000000000451.
  PMID: 27501016
  citation: Sepsas E, Misthos P, Anagnostopulu M, Toparlaki O, Voyagis G, Kakaris S. The role of intercostal cryoanalgesia in post-thoracotomy analgesia. Interact Cardiovasc Thorac Surg. 2013 Jun;16(6):814-8. doi: 10.1093/icvts/ivs516. Epub 2013 Feb 19.
  PMID: 23424242
  citation: Ju H, Feng Y, Yang BX, Wang J. Comparison of epidural analgesia and intercostal nerve cryoanalgesia for post-thoracotomy pain control. Eur J Pain. 2008 Apr;12(3):378-84. doi: 10.1016/j.ejpain.2007.07.011. Epub 2007 Sep 17.
  PMID: 17870625
  citation: Torre M, Mameli L, Bonfiglio R, Guerriero V, Derosas L, Palomba L, Disma N. A New Device for Thoracoscopic Cryoanalgesia in Pectus Excavatum Repair: Preliminary Single Center Experience. Front Pediatr. 2021 Jan 18;8:614097. doi: 10.3389/fped.2020.614097. eCollection 2020.
  PMID: 33585365
  citation: Lin J, Liao Y, Gong C, Yu L, Gao F, Yu J, Chen J, Chen X, Zheng T, Zheng X. Regional Analgesia in Video-Assisted Thoracic Surgery: A Bayesian Network Meta-Analysis. Front Med (Lausanne). 2022 Apr 6;9:842332. doi: 10.3389/fmed.2022.842332. eCollection 2022.
  PMID: 35463038
  citation: Fiorelli S, Leopizzi G, Menna C, Teodonio L, Ibrahim M, Rendina EA, Ricci A, De Blasi RA, Rocco M, Massullo D. Ultrasound-Guided Erector Spinae Plane Block Versus Intercostal Nerve Block for Post-Minithoracotomy Acute Pain Management: A Randomized Controlled Trial. J Cardiothorac Vasc Anesth. 2020 Sep;34(9):2421-2429. doi: 10.1053/j.jvca.2020.01.026. Epub 2020 Jan 21.
  PMID: 32144056
  citation: Taketa Y, Irisawa Y, Fujitani T. Comparison of ultrasound-guided erector spinae plane block and thoracic paravertebral block for postoperative analgesia after video-assisted thoracic surgery: a randomized controlled non-inferiority clinical trial. Reg Anesth Pain Med. 2019 Nov 8:rapm-2019-100827. doi: 10.1136/rapm-2019-100827. Online ahead of print.
  PMID: 31704789
  responsible party type: Principal Investigator
  investigator affiliation: University Hospital Padova
  investigator full name: Giovanni Maria Comacchio
  investigator title: Thoracic Surgeon
  mesh term: Thoracic Neoplasms
  mesh term: Pain, Postoperative
  sharing ipd: No