Abstract
Introduction: Erector spinae plane block (ESPB) is a novel inter-fascial plane block, which is applied more and more in postoperative pain control, especially in chest surgery. Attention is increasingly paid to its premium analgesia in urological surgery. Therefore, we aimed to explore whether ESPB would have similar analgesia compared with thoracic paravertebral block (TPVB) in laparoscopic nephroureterectomy surgery.Methods and analysis: This prospective, randomized, double-blinded, non-inferiority trial will enroll 166 patients undergoing laparoscopic nephroureterectomy. Participants will be randomly assigned 1:1 into receiving ESPB or TPVB before surgery. Both ultrasound-guided ESPB or TPVB will be performed with an injection of 0.375% ropivacaine 0.4ml/kg before anesthesia induction. Standardized patients controlled intravenous analgesia (PCIA) will be applied for each patient. The primary endpoint is the joint of cumulative 24h opioid (sufentanil) consumption and average pain score via numeric rating scale (NRS) at 24th h after surgery. Secondary endpoints include rescued analgesic demand, cumulative opioid consumption and pain NRS scores at different preset timepoint within 48h after surgery. Other predefined outcomes include clinical features of blockage, quality of recovery, subjective sleep quality, time to ambulation and flatus, and adverse events, as well as length of stay in hospital and anesthesia cost. Discussion: Previous studies investigating the analgesic efficacy of ESPB only concentrated on a single endpoint for postoperative pain evaluation, while studies focusing on the direct comparation between ESPB and TPVB in urological surgery is still lacking. Our study is the first trial in non-inferiority design of comparing ESPB and TPVB in patient undergoing laparoscopic nephroureterectomy surgery, and the primary outcome is the joint endpoint of opioid consumption and pain NRS score.Trial registration: Chinese Clinical Trial Registry, ChiCTR 2000031916. Registered on 14 April 2020. http://www.chictr.org.cn/showproj.aspx?proj=50782
Efficacy of ultrasound-guided erector spinae plane block following breast surgery - A double-blinded randomised, controlled study