Improving chest tube and pain management after surgery for spontaneous pneumothorax

Is this trial a fit for you?

A plain-English reading of the study's rules. Only the study team can confirm whether you qualify.

What this trial studies

This clinical trial aims to evaluate the optimal postoperative management of chest tubes and pain relief in patients who have undergone surgery for primary spontaneous pneumothorax. The study will compare traditional practices of leaving chest tubes in place for several days against the potential benefits of early removal on the same day of surgery. Additionally, it will assess different pain management techniques, including thoracic epidural analgesia and single-shot paravertebral blocks, to enhance recovery and reduce hospital stays. The goal is to establish evidence-based guidelines for postoperative care in this patient population.

Why it matters

Who can join: the full rules

Inclusion Criteria:

* All patients operated for PSP
* Age ≥ 16 years
* Able to read and understand the Dutch language
* Mentally able to provide informed consent
* Patients should have a preoperative chest CT scan in order to exclude evident secondary pneumothorax. Previously made CT scans, within a time range of maximum 5 years, are accepted. The identification of blebs or bullae on CT scan is not defined as secondary pneumothorax.

Exclusion Criteria:

* Previous ipsilateral thoracic surgery (except diagnostic thoracoscopy only) or ipsilateral thoracic radiotherapy
* Underlying lung disease that provoked the pneumothorax (secondary pneumothorax): genetically proven Birt-Hogg-Dubé syndrome, periodic pneumothorax in female patients in reproductive age with known endometriosis (or known catamenial pneumothorax), pulmonary cystic fibrosis, active pneumonia, lung fibrosis, chronic obstructive pulmonary disease (COPD), pulmonary ipsilateral malignancy
* Contra-indications for TEA (infection at skin site, increased intracranial pressure, non-correctable coagulopathy, sepsis and mechanical spine obstruction)
* Patients chronically (\>3 months) using opioids will be excluded since postoperative baseline opioid requirement will be higher and TEA remains the preferred technique for these patients
* Allergic reactions to analgesics used in the study

Where it's running

• Maxima MC
  Veldhoven, Netherlands Recruiting

Study contacts

• Study coordinator: Quirine C.A. van Steenwijk, MD
• Email: quirine.van.steenwijk@mmc.nl
• Phone: +31-40888-7243

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How to take part

1. Review the eligibility criteria above with your treating physician.
2. Check the official listing on ClinicalTrials.gov for the latest contact details and recruitment status.
3. Contact the study coordinator or principal investigator to ask for pre-screening. Pre-screening is free and never obligates you to enroll.