Paravertebral Analgesia Associated With Intravenous Morphine PCA After Thoracotomy
Status:
Completed
Trial end date:
2009-03-01
Target enrollment:
Participant gender:
Summary
osteolateral thoracotomy is a painful surgical procedure.Thoracic epidural analgesia (TEA) is
usually considered as the "gold standard" for postoperative thoracic analgesia.
Unfortunately, it's not always possible to realize it because of contraindications or because
of technical failures.Analgesia using a paravertebral block is an alternative to the TEA : it
provides an unilateral sensitive and sympathetic block using a catheter.In our study, the
catheter will be placed by the thoracic surgeon at the end of the surgical procedure, under
direct vision, to insure maximal security also on patients on antiplatelets agents,
anticoagulants or with haemostasis disorders (the placement of the catheter by the
anaesthetist with the loss of resistance technique is contraindicated in these
cases).Patients will be randomized to receive either a continuous 48-hours infusion of
ropivacaine 0,5% or saline serum in the control group.All patients are connected to a PCA
pump with intravenous morphine and will receive paracetamol and nefopam.The visual analogic
scale (VAS) at rest and on movement, total morphine consumption and side effects will be
recorded during the first 48 hours after surgery. The aim of this study is to prove a
decrease of pain at rest and on movement, a decrease of the cumulated total morphine dose
consumption and a decrease of the side effects (nausea, vomiting, pruritus, sedation,
bradypnea, urinary retention).