Effect of Left Erector Spinae Plane Block on Left Ventricular Functions

NCT06770816 | Not Yet Recruiting DMC

• 1 other identifier: 221
• Study Type: observational
• Target: 23
• Locations: 0 countries
• Sites: N/A

Brief Summary

Many studies have shown a decrease in inotropic status (intrinsic function) after blockade of cardiac sympathetic innervation with thoracic epidural anesthesia (TEA) (4,5). There is no study in the literature investigating the cardiac effects of left thoracic ESP block. We think that left thoracic ESP block, like TEA, may also have cardiac effects. Therefore, we aimed to investigate the effect of left thoracic ESP block on left ventricular functions with transthoracic echocardiography (TTE).

Conditions

Erector Spina Plan Block; Echocardiography

Keywords

erector spina plan block; left ventricle; echocardiography

Outcome Measures

Primary Outcomes (1)

• Echocardiographic assessment of left ventricular function

  Standard measurements of left ventricular systolic function include left ventricular volumes (indexed to body surface area, BSA), left ventricular ejection fraction (LVEF) according to the modified Simpson rule, time and velocity integral in the left ventricular outflow tract (TVI-LVOT), and stroke volume (SV) (= π x LVOT radius2 x TVI-LVOT). Stroke volume index (SVI) will be calculated as SV/BSA. Mitral and aortic Doppler flow profiles, left ventricular isovolumetric relaxation time, and maximum flow velocity measurements will be recorded. LV early (E-max) and late (A-max) diastolic filling will be assessed.

  Left ventricular function will be assessed by echocardiography 15 minutes before and 15 minutes after left high thoracic esp block.

Study Arms (1)

erector spina plan block

ESP block will be applied from the midline 3 cm lateral to the T5 level under ultrasound guidance. After the area is cleaned with povidone iodine before the block, the T5 transverse process will be determined using a linear ultrasound probe. Local anesthetic will be applied between the transverse process and the erector spinae muscle with the help of an insulated needle designed for peripheral block procedures. The location of the needle will be verified with the hydrodissection method with physiological serum without local anesthesia. After the location of the needle is verified, 0.25% bupivacaine 20 ml mixture will be applied.

Other: Echocardiography

Interventions

Echocardiography OTHER

HR, MAP, SBP and DBP will be recorded at baseline and 15 minutes after ESP block. Cardiac output (CO) will be calculated using echocardiographic data on stroke volume (SV) (measured from the LV outflow tract) and multiplied by HR. Changes in LV systolic function will be assessed with three parameters: fractional shortening (FS), ejection fraction (EF) using the Simpson method and S' wave of tissue Doppler imaging (TDI) of the mitral annulus (average of values at the medial and lateral annulus). LV diastolic function will be assessed with three parameters and interpreted according to the European Association of Cardiovascular Imaging guidelines. Pulsed wave (PW) Doppler of trans-mitral flow will be used to obtain the ratio between early (e) and late (atrial, a) waves. A PW Doppler between the LV outflow tract and the mitral valve will be performed to estimate the iso-volumetric relaxation time IVRT. TDI will be used to investigate myocardial relaxation at the mitral annular level (ear

erector spina plan block

Eligibility Criteria

• Age: 18 Years - 75 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Probability Sample

Study Population

Patients who will undergo elective left-sided thoracic surgery, ASA I-III and between the ages of 18-75

You may qualify if:

• Patients undergoing elective left-sided thoracic surgery ASA I-III 18-75 years of age

You may not qualify if:

• Refusal at enrollment
• Request for withdrawal from the study
• Inability to give informed consent
• Emergency surgery
• Bleeding diathesis
• Presence of contraindications to the LA agents used in this study
• Use of chronic opioids
• Psychiatric disorders
• Presence of infection at the injection site

Sponsors & Collaborators

• Aydin Adnan Menderes University: lead

Related Publications (1)

• Missant C, Claus P, Rex S, Wouters PF. Differential effects of lumbar and thoracic epidural anaesthesia on the haemodynamic response to acute right ventricular pressure overload. Br J Anaesth. 2010 Feb;104(2):143-9. doi: 10.1093/bja/aep354. Epub 2009 Dec 22.

  PMID: 20031952 BACKGROUND

Central Study Contacts

ferdi gülaştı

CONTACT

+905054929650; ferdigulasti@gmail.com

Study Design

• Study Type: observational
• Observational Model: OTHER
• Time Perspective: PROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: ass. prof.dr

Study Record Dates

• First Submitted: December 27, 2024
• First Posted: January 13, 2025
• Study Start: January 10, 2025
• Primary Completion: January 2, 2026
• Study Completion: February 2, 2026
• Last Updated: January 13, 2025

Record last verified: 2024-12