Analgesic efficacy of pre-emptive ultrasound-guided mid-point transverse process to pleura block for patients undergoing posterolateral thoracotomy incisions: Randomized controlled trial

Abstract

ABSTRACTBackground For anesthesiologists, managing pain during and after thoracic surgery remains a significant challenge. This research aims to assess the safety and efficacy of ultrasound (US)-guided pre-emptive mid-point transverse process to pleura (MTP) block for posterolateral thoracotomy.Methods This prospective randomized, double-blind clinical trial was conducted on 70 patients scheduled for a posterolateral thoracotomy operation under general anesthesia (GA). Patients were classified randomly and equally into Group I (MTP group) received MTP blocks, and Group II (sham block) received 2 ml of saline solution. The blocks were done after induction of GA but before the skin incision.Results Numerical rating scale (NRS) at rest and cough, total morphine consumption, the incidence of chronic pain at 3 months, and undesirable side effects (nausea, vomiting, respiratory depression) were significantly lower in MTP block than in sham block. Oxygen saturation and SpO2/FiO2 raised significantly in the MTP block than in the sham block (P < 0.001).Conclusions The US-guided MTP block provided effective analgesia with a lower pain score, lesser rescue analgesics consumption, and reduced risk of developing chronic pain posterolateral thoracotomy.

Keywords

• Mid-Point transverse process to pleura
• acute pain, chronic pain efficacy
• thoracotomy
• pre-emptive