Randomized Trial Comparing Intercostal Nerve Blocks, Cryo-ablation Plus Blocks, and Serratus Plane Catheter Plus Blocks After Minimally Invasive Esophagectomy

What this Trial Is About

This research investigates pain control methods for patients undergoing minimally invasive esophagectomy, a surgery on the esophagus. The study compares three approaches: local intercostal nerve blocks alone, cryo-ablation combined with intercostal nerve blocks, and serratus plane catheter plus intercostal nerve blocks. It is a pilot randomized controlled trial designed to evaluate which method may better manage acute postoperative pain in these patients. Participants will be randomly assigned to one of three groups before surgery. One group receives local intercostal nerve blocks with a specific dose of bupivacaine and epinephrine. Another group receives cryo-ablation near the sympathetic chain followed by the same nerve blocks. The third group receives serratus plane catheter blocks plus intercostal nerve blocks, including a continuous infusion of ropivacaine and daily boluses of bupivacaine with epinephrine for five days after surgery. Additional pain control with thoracic epidural catheters may be provided if needed. During the hospital stay, participants are monitored for pain every 12 hours up to four days after surgery. After discharge, follow-up continues for one year at a thoracic surgery clinic to collect further data. The main outcome measured is the change in postoperative pain from before surgery through the first four postoperative days. This study aims to provide detailed information on pain control effectiveness and safety during and after minimally invasive esophagectomy.

Minimally Invasive Esophagectomy Pain Control Trial