Evaluation of the Analgesia by Serratus Plane Block During Pleural Drainage in Intensive Care Unit.

Summary

Pleural drainage under local anesthesia is a frequent practice in resuscitation, experienced as an unpleasant and painful event for patients. Pain management is an important issue for early rehabilitation, decrease hospitalisation's cost and shortening the length of stay in intensive care unit (ICU). A new type of locoregional anesthesia called Serratus plane block described by Blanco in 2013 showed a benefit in per and postoperative analgesia in thoracic surgery and carcinologic breast surgery, allowing a decrease in morphine use and an improvement of the patient's general satisfaction. Serratus plane block is a very effective technique in chest wall analgesia, easy and safe to perform, with few complications. No studies to date have evaluated this anesthetic practice in intensive care for pleural drainage. This technique could be used outside the operating room to improve the intensive care patients, who often have heavier pathologies and greater pain, such as patients with chest trauma or patients with cardiac or respiratory disease. The investigators would like to conduct a preliminary study of superiority in the CHU Amiens intensive care unit, to study the interest of the Serratus plane block in comparison with local anesthesia on the management of acute pain during pleural drainage.

Conditions

• Analgesia
• Lidocaine
• Intensive Care Unit

Interventions

DRUG

lidocaine treatment

The index marks the upper edge of the lower rib of the selected intercostal space to avoid the vasculonervous bundle sitting at the lower part of the overlying rib.Non-targeted subcutaneous infiltration is performed in the drainage area with 5 to 10 mL of Lidocaine 20 mg / mL non-adrenaline, plane by plane, with regular aspiration until air or fluid confirming effusion.

DRUG

serratus plane block treatment

The Serratus plane block is located at the level of the 5th rib, on the midaxillary line, on the drainage side, ultrasound guided. The block is performed with a 70 mm needle in the ultrasound plane, and the needle is directed postero-inferior, after visualization of the structures from the surface to the depth: dorsal muscle * anterior serratus large muscle (serratus anterior) * intercostal muscle * 4th and 5th ribs * pleura A single injection of 30 mL of Ropivacaine 4.75 mg / mL is performed around the Serratus muscle. An intravenous injection of 8 mg of Dexamethasone is added to prolong the duration of the block.

Sponsors & Collaborators

• Centre Hospitalier Universitaire, Amiens

  lead OTHER

Principal Investigators

• Louise Badoux, MD · CHU amiens

• Stéphanie Malaquin, MD · CHU Amiens

• Osama Abou Arab, MD · CHU Amiens

Study Design

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

NONE

Model

PARALLEL

Eligibility

Min Age

18 Years

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2019-06-04

Primary Completion

2026-09-06

Completion

2026-09-06

Countries

• France

Study Locations