NCT07437027

Analgesic Efficiency of Erector Spinae Plane Block Versus Thoracic Paravertebral Block in Patients Undergoing Lateral Thoracotomy Using Opoid Sparing Anesthesia

Analgesic Efficiency of Erector Spinae Plane Block Versus Thoracic Paravertebral Block in Patients Undergoing Lateral Thoracotomy Using Opoid Sparing Anesthesia . A Comparative Study

• Status: Not Yet Recruiting
• Phase: N/A
• Study type: Interventional
• Enrollment: 86 (estimated)
• Sponsor: Cairo University · Academic / Other
• Sex: All
• Age: 18 Years – 70 Years
• Healthy volunteers: Not accepted

Summary

AimoftheWork To assess the efficiency of Opoid free anaesthesia with paravertebral block compared to opoid free anaesthesia with erector spinae plane block in patients undergoing Thoracotomy.

Detailed description

There is growing evidence showing that opoid-free anesthesia (OFA), including loco-regional anesthesia and non-opioid drugs, is feasible in several surgical settings. The surgeries for pathologies involving the lungs and mediastinum involves different types of thoracic surgical incision such as anterolateral or posterolateral. Post thoracotomy pain affects 30%-50% of the patients undergoing thoracotomy.Poorly managed pain following thoracotomy can lead to increase the risk of complications such as lung collapse and chest infections due to altered mechanical functions of the lungs and ventilation-perfusion mismatch. Acute thoracotomy pain is multifactorial in nature. It involves nociceptive and neuropathic mechanisms originating from somatic and visceral afferents. The main sources of pain are intercostal nerves,the vagus nerve and phrenic nerve in the pleura, the superficial cervical plexus, and the brachial plexus in the ipsilateral shoulder. So, Analgesia is a major determinant of balanced anesthesia and it is usually achieved by administering opioid agents, which are well tolerated and maintain hemodynamic stability in the perioperative period. However, perioperative opioid administration is not risk-free. Opioids are associated with life-threatening side effects such as respiratory depression, postoperative nausea and vomiting, opioid-induced hyperalgesia, constipation, urinary retention, immunomodulation and neurotoxicity. In addition, opioid prescription after surgery seems to trigger the development of opioid addiction, thus contributing to the widespread opioid misuse observed worldwide. Several studies found a correlation between postoperative opioid administration, the development of chronic pain and opioid addiction. Therefore,opioid administration should be reduced or avoided as much as possible. Thoracic epidural analgesia (TEA) is considered as the gold standard for thoracotomy pain(4)However, according to a recent systematic review, The thoracic paravertebral block (TPVB) has been shown to be as effective as TEA with reduction of the risks of minor complications compared to TEA. Emerging research has shown that the novel erector spinaeplane block(ESPB) can be employed as a simple and safe alternative analgesic technique for acute postsurgical, post-traumatic, and chronic neuropathic thoracic pain in adults. The goal of this study is to assess the Analgesic efficiency of erector spinae plane block versus thoracic paravertebral block in patients undergoing lateral thoracotomy using opoid sparing anesthesia.

Conditions

• Post Thoracotomy Pain

Interventions

Type	Name	Description
PROCEDURE	Group A :Thoracic paravertebral block	Ultrasound guided thoracic paravertebral block performed at the T5 level using 20 ml of 0.5% bupivacaine for postoperative analgesia in patients undergoing lateral thoracotomy
PROCEDURE	Erector Spinae Plane Block	ultrasound guided erector spinae plane block will be performed at the T5 level using 20 ml of 0.5% bupivacaine as part of an opoid sparing anesthesia protocol for lateral thoracotomy

Timeline

• Start date: 2026-03-01
• Primary completion: 2026-06-01
• Completion: 2026-07-01
• First posted: 2026-02-27
• Last updated: 2026-02-27

Locations

1 site across 1 country: Egypt