Overview
This prospective randomized double-blinded controlled study will be conducted to evaluate the effect of adding calcitonin to bupivacaine in thoracic paravertebral block for patients undergoing thoracotomy.
Description
Single-shot thoracic paravertebral block combined with intravenous analgesia is one of the regional techniques used for controlling pain in patients undergoing thoracic surgery. However, few articles demonstrated its effects on acute pain and chronic pain after thoracotomy and revealed high postoperative opioid consumption and inability to reduce the incidence of chronic pain.
Calcitonin has previously been shown to be effective in the management of acute pain following amputation, vertebral fractures and other neuropathic conditions.
Using calcitonin as an additive in thoracic paravertebral block was not evaluated in previous studies, we conducted this study as we hypothesize that calcitonin use as an additive in thoracic paravertebral block for patients undergoing thoracotomy may have extended analgesic effects regarding decreasing postoperative pain scores, opioid consumption, and this value may decrease the incidence of chronic post-thoracotomy pain.
In both groups, ultrasound-guided thoracic paravertebral block will be performed before anesthetic induction using a high-frequency linear probe after identifying the paravertebral space of the proposed level of intercostal skin incision.General anesthesia in both groups will be similar.
Eligibility
Inclusion Criteria:
- aged ≥ 18 years
- American society of anesthesiology (ASA) physical status of I-III
- scheduled for elective thoracotomy
Exclusion Criteria:
- Contraindication to thoracic paravertebral block as coagulopathy or local anesthetic allergy.
- Pregnancy
- History of cardiovascular and gastro-esophageal surgery
- Preexisting pain syndrome or psychological disorders
- Severe hepatic, cardiovascular, or renal disorders
- Allergy to calcitonin
- Patients who will be re-operated and who will report infections