Costotransverse Foramen Block Versus Thoracic Paravertebral Block in Thoracotomy for Lung Cancer

January 24, 2026 updated by: Mai Mohamed El Rawas, National Cancer Institute, Egypt

Costotransverse Foramen Block Versus Thoracic Paravertebral Block in Thoracotomy for Lung Cancer: A Randomized Controlled Trial

This study aims to compare the costotransverse foramen block (CTFB) with thoracic paravertebral block (TPVB) in patients undergoing thoracotomy for lung cancer.

Study Overview

Status

Recruiting

Conditions

Intervention / Treatment

Detailed Description

Thoracotomy is known to be one of the most painful surgeries. Managing post-thoracotomy pain is a major clinical challenge, as about 75% of patients report moderate to severe pain afterward.

Various regional and central analgesia techniques, such as thoracic epidural analgesia (TEA), thoracic paravertebral block (TPVB), and erector spinae plane block (ESPB), are employed in a multimodal approach. Although TEA has traditionally been considered the gold standard for thoracotomy pain control, concerns about its side effects have prompted the exploration of alternatives.

The costotransverse foramen block (CTFB), a recently introduced technique, has been examined in both cadaveric and case studies.

Study Type

Interventional

Enrollment (Estimated)

70

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Locations

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  • Age > 18 years and ≤ 65 years old.
  • American Society of Anesthesiologists (ASA) physical status II-III.
  • Body mass index 18-35 kg/m2.
  • Patients scheduled for thoracotomies for lung cancer.

Exclusion Criteria:

  • Patient refusal.
  • History of sensitivity to local anesthetics.
  • History of psychological disorders.
  • Contraindication to regional anesthesia, e.g., local sepsis, pre-existing peripheral neuropathies, and coagulopathy.
  • Severe respiratory, cardiac, hepatic, or renal disease.
  • Morbid obesity.
  • Uncooperative patients.
  • Patients on chronic pain therapy.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Double

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: CTFB Group
Patients will receive an ipsilateral ultrasound-guided costotransverse foramen block with injection of 20 ml bupivacaine 0.25%.
Other: Costotransverse foramen block
Patients will receive an ipsilateral ultrasound-guided costotransverse foramen block with injection of 20 ml bupivacaine 0.25%.
Experimental: TPVB Group
Patients will receive an ipsilateral ultrasound-guided thoracic paravertebral plane block with injection of 20 ml bupivacaine 0.25%.
Other: Thoracic paravertebral plane block
Patients will receive an ipsilateral ultrasound-guided thoracic paravertebral plane block with injection of 20 ml bupivacaine 0.25%.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Total morphine consumption
Time Frame: 24 hours postoperatively
If the visual analog scale (VAS) is ≥ 4, rescue analgesics will be administered in the form of a 4 mg bolus of morphine.
24 hours postoperatively

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Intraoperative fentanyl consumption
Time Frame: Intraoperatively
Intraoperative fentanyl consumption will be recorded.
Intraoperatively
Duration of analgesia
Time Frame: 24 hours postoperatively
Duration of analgesia will be recorded from the end of surgery till first dose of morphine administrated.
24 hours postoperatively
Degree of pain
Time Frame: 48 hours postoperatively
Each patient will be instructed about postoperative pain assessment with the visual analog scale (VAS). VAS (0 represents "no pain" while 10 represents "the worst pain imaginable"). VAS will be recorded in post-anesthesia care unit (PACU) and after 1, 6, 12, 24 & 48 hours postoperatively
48 hours postoperatively
Mean arterial blood pressure
Time Frame: 4 hours postoperatively
Mean arterial blood pressure will be recorded before induction of general anesthesia to be defined as the baseline reading. Another reading will be noted immediately before surgical incision and at 20-minute intervals intraoperatively, and then hourly for the next 4 hours postoperatively.
4 hours postoperatively
Heart rate
Time Frame: 4 hours postoperatively
Heart rate will be recorded before induction of general anesthesia to be defined as the baseline reading. Another reading will be noted immediately before surgical incision and at 20-minute intervals intraoperatively, and then hourly for the next 4 hours postoperatively.
4 hours postoperatively
Incidence of block-related side effects
Time Frame: 4 hours postoperatively
Incidence of block-related side effects such as unexpected epidural anesthesia, pneumothorax, total spinal anesthesia, or local anesthetic intoxication will be recorded.
4 hours postoperatively
Incidence of side effects
Time Frame: 4 hours postoperatively
Incidence of side effects such as postoperative nausea and vomiting, drowsiness, or dyspnea will be recorded.
4 hours postoperatively

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

National Cancer Institute, Egypt

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

January 24, 2026

Primary Completion (Estimated)

June 1, 2026

Study Completion (Estimated)

June 1, 2026

Study Registration Dates

First Submitted

January 17, 2026

First Submitted That Met QC Criteria

January 17, 2026

First Posted (Actual)

January 26, 2026

Study Record Updates

Last Update Posted (Actual)

January 27, 2026

Last Update Submitted That Met QC Criteria

January 24, 2026

Last Verified

January 1, 2026

More Information

Terms related to this study

Additional Relevant MeSH Terms

Other Study ID Numbers

  • AP2512-501-141-205

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

YES

IPD Plan Description

The data will be available upon a reasonable request from the corresponding author after the end of study for one year.

IPD Sharing Time Frame

After the end of study for one year.

IPD Sharing Access Criteria

The data will be available upon a reasonable request from the corresponding author.

IPD Sharing Supporting Information Type

  • STUDY_PROTOCOL

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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