Clinical trial · Interventional
Erector Spinae Plane Block Versus Intercostal for VATS
Ultrasound-Guided Erector Spinae Plane Block Versus Intercostal Nerve Block For Postoperative Pain Control in Video-Assisted Thoracoscopic Surgery: A Prospective, Double Blind Randomized Controlled Trial
- Source
- ClinicalTrials.gov
- Retrieved
- Sep 8, 2026
- Layer
- normalized (units and labels harmonized; values unchanged)
- Run
- ING-CLINICALTRIALS-20260908-000001
Summary
Brief summary (as posted)
The Erector Spinae Plane (ESP) block is a new interfascial regional anesthesia technique recently described by Forero et al. Currently the literature shows the ESP block being used for analgesia after thoracic surgery, breast surgery, abdominal surgery (visceral abdominal analgesia in bariatric surgery, ventral hernia repair, cholecystectomy), thoracic vertebral surgery and for pain relief in rib fractures. Taking in consideration the excellent clinical experience, but the lack of strong and high-quality evidence, supporting the use of ESP block for pain management in patients undergoing VATS procedures, there is a specific interest to develop a prospective study. Comparing the effect of the current pain relief strategy at the MGH (intercostal nerve block by the surgeon at the end of the procedure ) versus ESP block after VATS, seems warranted to improve current clinical results.
Conditions
Conditions (2)
Free-text conditions as registered, with the CancerIndex entity they were reconciled to and the match type.
| Condition (as posted) | Mapped entity | Match | Confidence |
|---|---|---|---|
| Lung Cancer | Malignant Lung Neoplasm | CURATED_EXACT | 0.92 |
| Lung Diseases | — | UNRESOLVED | — |
Interventions
Interventions (7)
| Intervention | Type | Mapped drug | Match |
|---|---|---|---|
| Bupivacaine-epinephrine | Drug | — | UNRESOLVED |
| Dexamethasone injection | Drug | Dexamethasone | ALIAS |
| ESP block | Procedure | — | UNRESOLVED |
| Intercostal block | Procedure | — | UNRESOLVED |
| Normal saline | Drug | — | UNRESOLVED |
| Sham ESP block | Procedure | — | UNRESOLVED |
| Sham Intercostal block | Procedure | — | UNRESOLVED |
Design
Arms and outcomes
Arms (2)
- type
- EXPERIMENTAL
- label
- ESP block
- description
- patients will receive an ultrasound guided ESP block (technique as described by Forero et al) under strict sterile conditions in the operating room area. After identifying the T5 transverse process (TP) and after infiltration of lidocaine 2% subcutaneously. A 22g 100mm block needle will be advanced under vision, in a cephalad to caudad direction, until the tip contacts the T5 TP. 20 ml of 0.25% bupivacaine with 5 mcg/ml of epinephrine and 10 mg dexamethasone will be injected under the erector spinae muscle. A visible separation of the erector spinae muscle from the TP will be the sign of a successful block. A 20 ml syringe of Normal Saline will be given to the surgeon (unaware of the content) at the end of the surgery, for the intercostal nerve block as per standard present technique.
- interventionNames
- Procedure: ESP block
- Procedure: Sham Intercostal block
- Drug: Bupivacaine-epinephrine
- Drug: Dexamethasone injection
- Drug: Normal saline
- type
- SHAM_COMPARATOR
- label
- ESP sham block
- description
- patients will receive an ultrasound guided sham ESP block under strict sterile conditions in the operating room area as described above. 20 ml of Normal Saline will be injected under the erector spinae muscle. A 20 ml syringe of 0.25% bupivacaine with 5 mcg/ml of epinephrine and 10 mg dexamethasone will be given to the surgeon (blinded to the content) at the end of the surgery for the intercostal nerve block.
Eligibility
Eligibility (as posted)
- Sex
- All
- Minimum age
- 18 Years
- Maximum age
- 80 Years
Show eligibility criteria text
Inclusion Criteria: * Male and female patients * age between 18 to 80 years old * ASA 1-3 * scheduled for VATS * informed consent explained and signed Exclusion Criteria: * Patients \< 18 years old, \> 80 years old * ASA physical status \> 3 * morbid obesity (BMI \>40) * previous cardiac surgery or ipsilateral thoracic surgery * neuropsychiatric diseases * serum albumin \< 35 g/L * cardiac, renal (creatinine \> 200mmol/l) or hepatic failure (aspartate amino transferase, alanine amino transferase \> 50 % over the normal range) * anemia (hematocrit \<30%) * organ transplant * allergy to analgesics or local anesthetics or other medications used in the study * abuse of opioids or sedatives * contraindication to receive regional anesthesia (e.g. coagulation defect) * patients who could not understand the VAS pain-scoring system * patient refusal to follow participation * intraoperative conversion to open thoracotomy * revision or re-operation or complication of surgery during the follow-up time * post operative mechanical ventilation * intolerance or allergy to any prescribed medication
References
Publications (0)
Data not yet available