NCT07063602

Sensory Anesthesia Achieved Through Different Paravertebral Block Approaches for Post-Op Pain Management After VATS Lung Resection

Sensory Anesthesia Achieved Through Different Paravertebral Block Approaches for Post-Operative Pain Management After Videothoracoscopic Lung Resection

• Status: Recruiting
• Phase: —
• Study type: Observational
• Enrollment: 90 (estimated)
• Sponsor: Centre hospitalier de l'Université de Montréal (CHUM) · Academic / Other
• Sex: All
• Age: 18 Years
• Healthy volunteers: Not accepted

Summary

Video-assisted thoracoscopic lung resection (VATS) is a minimally invasive surgical approach frequently used in the treatment of lung cancers. The most commonly used analgesic technique for this surgery is the paravertebral block with a single peroperative injection of local anesthetic. However, a recent study conducted at our institution revealed that this approach provided less relief than expected in some patients. In light of these results, it becomes crucial to distinguish between technical failures (absence of sensitive anesthesia) and the intrinsic limits of the chosen regional analgesia technique (pain originating from an unanesthetized area or pain despite the presence of sensitive anesthesia) in order to better relieve patients. This study aims to objectively assess the areas of anesthesia obtained through three methods of paravertebral block to evaluate their respective performance and optimize post-VATS analgesic management.

Detailed description

Video-assisted thoracoscopic lung resection (VATS) is a minimally invasive surgical approach frequently used in the treatment of lung cancers. Compared to traditional thoracotomy, it is associated with reduced acute postoperative pain and a faster recovery. However, this pain often remains moderate to severe and can, if poorly controlled, promote the development of chronic pain. A multimodal analgesic strategy is essential to limit the use of opioids and their side effects. The most commonly used analgesic technique is the paravertebral block. As part of the optimized recovery protocols at our institution, a single peroperative injection of local anesthetic, guided by thoracoscopy, is currently favored. This technique, which is simple and safe, promotes rapid mobilization of the patient. However, a recent study conducted at our institution revealed that this approach provided less relief than expected in some patients. In light of these results, it becomes crucial to distinguish between technical failures (absence of sensitive anesthesia) and the intrinsic limits of the chosen regional analgesia technique (pain originating from an unanesthetized area or pain despite the presence of sensitive anesthesia) in order to better relieve patients. This study aims to objectively assess the areas of anesthesia obtained through three methods of paravertebral block to evaluate their respective performance and optimize post-VATS analgesic management. The primary objective of the study is to compare the success rate of creating sensitive anesthesia of the thoracic wall in the acute postoperative phase of video-assisted thoracoscopic lung resection according to various administration methods (transpleural approach by the surgeon vs percutaneous approach by the surgeon vs ultrasound guided approach by the anesthesiologist).

Conditions

• Thoracic Surgery
• Video-assisted
• Paravertebral Block

Interventions

Type	Name	Description
OTHER	Evaluation of the hypoesthesia of the thorax	In the recovery room, a member of the research team will come to assess the presence of hypoesthesia (loss of sensation) of the thorax using ice and a Von Frey filament applied at three different sections: midscapular, midaxillary and midclavicular.

Timeline

• Start date: 2025-09-10
• Primary completion: 2026-09-10
• Completion: 2026-09-10
• First posted: 2025-07-14
• Last updated: 2026-02-27

Locations

1 site across 1 country: Canada