Clinical trial NCT06987136: Transversus Thoracic Muscle Plane Block, Erector Spinae Plane Block and Paravertebral Block for Analgesia in Video-Assisted Thoracic Surgery
Official title: A Randomized Clinical Trial Comparing Transversus Thoracic Muscle Plane Block, Erector Spinae Plane Block and Paravertebral Block for Analgesia in Patients Undergoing Video-Assisted Thoracic Surgery
Study type: INTERVENTIONAL
Overall status: RECRUITING
Phase: NA
Conditions: Transversus Thoracic Muscle Plane Block
Erector Spinae Plane Block
Paravertebral Block
Analgesia
Video-Assisted Thoracic Surgery
Lead sponsor: Tanta University
Sponsor class: OTHER
First posted: 2025-05-23
Enrollment: 60
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: TREATMENT

Brief summary: The aim of this study is to compare the transversus thoracic muscle plane block (TTPB), erector spinae plane block (ESPB), and thoracic paravertebral block (TPVB) for postoperative analgesia in patients undergoing video-assisted thoracoscopic surgery (VATS).

Detailed description: Traditionally, resection is done via a thoracotomy. Still, video-assisted thoracoscopic surgery (VATS) provides significant advantages over open thoracotomy procedures, including reduced surgical pain, improved postoperative pulmonary function, reduced mortality, shortened hospital stay. It has emerged as a minimally invasive alternative.

Thoracic paravertebral block (TPVB) is a regional anesthetic technique in which local anesthetic (LA) is administered inside the thoracic paravertebral space (TPVS), which contains the intercostal spinal nerves, spinal dorsal rami, rami communicants, sympathetic chain, intercostal vessels, and fatty tissue.

The erector spinae plane block (ESPB) is an interfascial regional anesthesia block for thoracic analgesia which can be performed by superficial or deep needle approach.

Transversus thoracic muscle plane block (TTPB) is a newly developed technique in which LA is injected into the fascial plane between the transversus thoracic muscle and the internal intercostal muscles for blocking the anterior cutaneous branches of intercostal nerves from thoracic (Th) 2 to Th 6.

Eligibility criteria: Inclusion Criteria:

* Age ≥ 18 years.
* Both sexes.
* American Society of Anesthesiology (ASA) physical status I-II.
* Scheduled for video-assisted thoracic surgery under general anesthesia.

Exclusion Criteria:

* Body mass index \>30 kg/m2.
* Coagulopathy.
* History of opiate abuse.
* Pre-existing chronic pain.
* Allergy to local anesthetics or analgesics.
* Infection at the site of injection.
* Mental or neurological disorders.
* Operation converted to open thoracotomy.
* Renal dysfunction (glomerular filtration rate (GFR) \< 50 ml/min).
* Pregnancy

Primary outcomes:
measure: Time to the 1st rescue analgesia
timeFrame: 24 hours postoperatively
Secondary outcomes:
measure: Total morphine consumption
timeFrame: 24 hours postoperatively
measure: Degree of pain
timeFrame: 24 hours postoperatively
measure: Heart rate
timeFrame: Till the end of surgery (Up to 2 hours)
measure: Mean arterial pressure
timeFrame: Till the end of surgery (Up to 2 hours)
measure: Degree of patient satisfaction
timeFrame: 24 hours postoperatively
measure: Incidence of complications
timeFrame: 24 hours postoperatively
Other outcomes:
Locations:
city: Tanta
country: Egypt
facility: Tanta University
state: El-Gharbia
Study officials:
References: