Effect of Patient Position on Erector Spinae Plane Block in Thoracic Surgery

February 4, 2026 updated by: Ekin Guran, MD, Dr Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital

Effect of Patient Position on Dermatomal Spread and Analgesic Outcomes of Erector Spinae Plane Block in Thoracic Surgery: A Prospective Randomized Clinical Trial

The erector spinae plane (ESP) block is a widely used regional anesthesia technique for postoperative analgesia in thoracic surgery. The block can be performed in different patient positions, most commonly sitting or lateral decubitus, but the effect of patient position on dermatomal sensory spread and analgesic efficacy has not been clearly established.

This prospective, randomized, single-blind clinical trial aims to compare the effects of ESP block performed in sitting versus lateral decubitus position on dermatomal sensory distribution and postoperative analgesic outcomes in patients undergoing video-assisted thoracic surgery.

Study Overview

Status

Not yet recruiting

Conditions

Intervention / Treatment

Detailed Description

Adult patients scheduled for elective video-assisted thoracic surgery will be randomly assigned to receive ultrasound-guided unilateral erector spinae plane block either in the sitting position or in the lateral decubitus position. In both groups, the block will be performed at the same thoracic level using 30 mL of 0.25% bupivacaine under ultrasound guidance.

Dermatomal sensory spread will be assessed 15 minutes after block placement using cold sensation (alcohol-soaked cotton) and pin-prick testing. Postoperative analgesia will be standardized in all patients using patient-controlled analgesia with tramadol. Pain scores and opioid consumption will be recorded during the first 24 postoperative hours.

The primary outcome is the extent of dermatomal sensory spread. Secondary outcomes include postoperative pain scores, time to first rescue analgesic, and total opioid consumption within 24 hours.

Study Type

Interventional

Enrollment (Estimated)

90

Phase

  • Not Applicable

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 to 75 years
  • ASA physical status II-IV
  • Scheduled for elective video-assisted thoracic surgery
  • Ability to provide written informed consent

Exclusion Criteria:

  • Known allergy to local anesthetics
  • Chronic opioid use
  • Preexisting chronic pain
  • Severe cognitive impairment
  • Technical difficulty with positioning
  • Emergency surgery
  • Refusal to participate

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
Active Comparator: Sitting Position Group
Intervention: Erector Spinae Plane Block Ultrasound-guided unilateral erector spinae plane block performed in the sitting position using 30 mL of 0.25% bupivacaine.
Drug: Erector Spinae (ESP) Block with Bupivacaine (Marcaine®) sitting position
Erector spinae plane block-sitting position
Experimental: Lateral Decubitus Position Group
Intervention: Erector Spinae Plane Block Ultrasound-guided unilateral erector spinae plane block performed in the lateral decubitus position (operative side up) using 30 mL of 0.25% bupivacaine.
Drug: Erector Spinae (ESP) Block with Bupivacaine (Marcaine®) lateral position
Erector Spinae Plane Block-Lateral position

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Dermatomal sensory spread
Time Frame: 15 minutes after the block application
Cranial and caudal sensory limits and total number of dermatomes affected, assessed by cold sensation and pin-prick testing.
15 minutes after the block application

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Total opioid consumption
Time Frame: First 24 postoperative hours
First 24 postoperative hours
Postoperative pain scores (Numeric Rating Scale)
Time Frame: Postoperative 0, 2, 6, 12, and 24 hours
Numeric Rating Scale, 0-10 points, 0=no pain, 10= worst pain imaginable
Postoperative 0, 2, 6, 12, and 24 hours

Collaborators and Investigators

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

Sponsor

Dr Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital

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 (Estimated)

February 1, 2026

Primary Completion (Estimated)

April 1, 2026

Study Completion (Estimated)

May 1, 2026

Study Registration Dates

First Submitted

January 28, 2026

First Submitted That Met QC Criteria

January 28, 2026

First Posted (Actual)

February 4, 2026

Study Record Updates

Last Update Posted (Actual)

February 6, 2026

Last Update Submitted That Met QC Criteria

February 4, 2026

Last Verified

February 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • ESP_position

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

YES

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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