Comparison effect of ultrasound guided erector spinalis plane block and parascapular sub ilio-costalis plane block on the pain control after video associated thoracic surgery

Comparison effect of ultrasound guided erector spinalis plane block and parascapular sub ilio-costalis plane block on the postoperative pain control after video associated thoracic surgery

Clinical trial, parallel groups, double-blind, randomized, phase 3 on 40 patients. In order to randomize, the block randomization method will be used.

In this research, all patients requiring video associated thoracic surgery, referred to Firouzgar and Rasoul Akram Hospitals in Tehran, will be included in the study.Patients will be randomly divided into 2 groups based on blocks of 4. The sample size for each study group is 30 people. A total of 40 patients will be examined. Patients, surgeon and data analyst will be blinded.

Inclusion criteria: Patients undergoing video associated thoracic surgery, A person with normal health, A person with mild systemic disease, Age between 20-60 years. Non-entry criteria: Emergency patients with organic problems, History of sensitivity to ropivacaine, Patients who have received analgesics in the last day, Patients with body mass index less than 35, Patients with underlying liver and kidney disease and coagulopathy or a history thereof, Patients who are addicted to opioids.

Intervention group 1: In this group, before the start of surgery, patients under erector spina plain block are placed under ultrasound guidance with a linear prop on the surgical side. Intervention group 2: In the second group, before the start of surgery, patients are placed under sub ilio-costalis block with the help of ultrasound guidance with a linear prop on the surgical side

Severity of patients' pain

Patients will be randomly divided into two groups. The randomization tool will be a random sequence generation software called SAS. In addition to simple randomization, these random sequence generation software are capable of generating random sequence by block method. Block randomization method will be used for randomization. Block randomization is for the purpose of making sure that exactly equal number of participants enter the study groups. The advantages of block randomization are that the balance of the number of participants in each group is guaranteed. For this purpose, 4 blocks will be formed and in each block, 2 people from intervention group and 2 people in control group will be placed. A total of 10 blocks will be considered to reach the sample size. The blocks contain numbers, odd numbers represent the intervention group and even numbers represent the control group. Their order will be determined by the software initially. In order to hide the random allocation, opaque envelopes sealed with a random sequence will be used. In this method, each of the generated random sequences will be recorded on a card and the cards respectively will be placed in the envelopes. In order to maintain a random sequence, the outer surface of the envelopes is numbered in the same order. Finally, the lid of the letter envelopes is glued and placed in a box. At the time of registration of participants, based on the order of entry of qualified participants into the study, one of the envelopes will be opened in order and the assigned group of that participant will be revealed.

Patients will be blinded to the type of block. Patients will be aware that they will be randomly assigned to one of the two treatment groups, but will not know which block will be provided in that group. Patients will be assigned to one of two groups using a random number table. The person in charge of data collection, the analyst and the outcome evaluator will collect and analyze the data based on groups 1 and 2 and will not know the type of treatment provided in the groups and will be kept blind.