Pain Management After VATS for Postoperative Pain

Recruiting in Palo Alto (17 mi)

Overseen byYatish Ranganath, MD

Age: 18+

Sex: Any

Travel: May Be Covered

Time Reimbursement: Varies

Trial Phase: Phase 2

Waitlist Available

Sponsor: Nada Sadek

No Placebo Group

Prior Safety Data

Trial Summary

What is the purpose of this trial?Video-assisted thoracoscopic surgery (VATS) greatly decreased the number and types of surgery that required open thoracotomy. Initially it was thought that VATS would lead to a reduction of respiratory problems and less acute pain in patients when compared to patients receiving an open thoracic surgery. However, for reasons not clearly understood, a large number of patients who undergo VATS still experience moderate to severe post-surgical pain (1). Physicians are still faced with the challenge of providing care that will manage both the respiratory issues as well as manage acute pain. The goal of this study is to find the most suitable regimen to effectively manage post-VATS-related pain.

Eligibility Criteria

This trial is for adults aged 18-80 undergoing VATS who are not pregnant, have a BMI under 40, and can consent. It excludes those with chronic pain conditions, opioid tolerance, allergies to study drugs, infectious diseases, coagulation issues, severe liver disease or incarceration.

Inclusion Criteria

I am between 18 and 79 years old.

I am scheduled for a minimally invasive chest surgery.

You weigh less than 40 times your height in kilograms.

Exclusion Criteria

I have severe liver disease.

My blood does not clot properly.

I have had a surgery to fuse my lung lining using a camera-assisted technique.

+10 more

Participant Groups

The study tests two types of pain management medications after VATS: Bupivacaine and Liposomal bupivacaine. The aim is to determine which provides better post-surgical pain relief without causing respiratory problems.

2Treatment groups

Experimental Treatment

Active Control

Group I: Liposomal bupivacaineExperimental Treatment1 Intervention

The patient will receive an intercostal nerve block by the surgeon in the operating room after anesthetic has been administered. The surgeon will use thoracoscopic guidance to administer the intercostal nerve block. The medication used in this block will liposomal bupivacaine (Exparel).

Group II: BupivacaineActive Control1 Intervention

The patient will receive a paravertebral block by the anesthesiologist staffing the pain service area within the hospital prior to surgery. This regional anesthesia will be done using ultrasound guidance. The medication used in this block will be plain bupivacaine with epinephrine.