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

February 22, 2026 updated by: Mahmoud Mohamed Mustafa, Cairo University

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

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.

Study Overview

Status

Not yet recruiting

Conditions

Intervention / Treatment

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.

Study Type

Interventional

Enrollment (Estimated)

86

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

  • Name: Eman Mamdouh Mahmoud Hussien (emanmmh), Assistant lecturer
  • Phone Number: 201002087146
  • Email: Eman.mamdouh31@gmail.com

Study Locations

  • Egypt
    • Kasr Alaini
      • Cairo, Kasr Alaini, Egypt
        • Kasr Al Aini Hospital

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:

  • Patients age between 18 and 70 .
  • Patients with ASAII and IIIstatus.
  • Patients undergoing open surgical Thoracotomy as in lobectomy, pneumonectomy, segmentectomy and decortication.

  • Gender both males and females.

    2.Exclusioncriteria

    1. Refusal of the patient.
    2. Allergy to local anesthetic
    3. Infection of the skin at the site of local infiltration
    4. Cardiovascular problems (arrhythmia, heart block, SVT,AF, multiple extra systole).
    5. Any contraindication to regional anesthesia as coagulopathy
    6. Patients with chronic pain or on opoid medication preoperative

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: Quadruple

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Group A : thoracic para vertebral block
Patients in this arm will receive ultrasound guided thoracic paravertebral block at the T5 level using 20 ml of 0.5% bupivacaine protocol for lateral thoracotomy
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
Experimental: Group B : erector spinae plane block
Patients in this arm will receive ultrasound guided erector spinae plane block at the T5 level using 20 ml of 0.5% bupivacaine as part of an opoid sparing anesthesia protocol for 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

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Time Frame
Total morphine consumption for the first 24 hours postoperative
Time Frame: Within the first 24 hours postoperative
Within the first 24 hours postoperative

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Postoperative pain
Time Frame: At 0,2,6,12,24 hours post operative
Postoperative pain will be assessed using vas score at 0,2,6,12,24 hours post operative
At 0,2,6,12,24 hours post operative

Collaborators and Investigators

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

Sponsor

Cairo University

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

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)

March 1, 2026

Primary Completion (Estimated)

June 1, 2026

Study Completion (Estimated)

July 1, 2026

Study Registration Dates

First Submitted

February 22, 2026

First Submitted That Met QC Criteria

February 22, 2026

First Posted (Actual)

February 27, 2026

Study Record Updates

Last Update Posted (Actual)

February 27, 2026

Last Update Submitted That Met QC Criteria

February 22, 2026

Last Verified

February 1, 2026

More Information

Terms related to this study

Keywords

Other Study ID Numbers

  • Post thoracotomy pain

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

UNDECIDED

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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