Ultrasound Guided Erectror Spinae Block Versus Intracavitary During Medical Thoracoscopy (ESPB)

Ultrasound-Guided Erector Spinae Plane Block Versus Intracavitary Local Anaesthesia for Peri-procedural Analgesia During Medical Thoracoscopy: A Randomized Control Trial

The primary aim: is to compare the effect of US guided ESP block at two levels versus intracavitary blockade in medical thoracoscopy on total peri-procedural (intraoperative and post-operative 12 hours) nalbuphine consumption (mg) during medical thoracoscopy. Secondary aims: Time to first rescue analgesia, postoperative VAS, haemodynamics, recovery time (Aldert > 9), and adverse events

Study Overview

• Status: Not yet recruiting
• Conditions: PLEURA DISEASE
• Intervention / Treatment: Procedure: ultrasound-guided erector spinae plane block in medical pleuroscopy; Procedure: Intracavitary anaesthesia ICA

• Study Type: Interventional
• Enrollment (Estimated): 100
• Phase: Phase 2; Phase 3

Contacts and Locations

• Study Contact: Name: Donia Hany Hany, MD; Phone Number: 01014498540; Email: doniahany1788@gmail.com

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• 100 patients belonging to American Society of Anesthesiologists (ASA) I-III scheduled for medical thoracoscopy under adequate sedation and analgesia.

Exclusion Criteria:

• Patients will be excluded if; history of allergy or contraindication to any of the studied drugs, BMI more than 35 kg/m2 chronic opioid use or abuse, patients for whom ESPB block is contraindicated (patient refusal, coagulation disorder, skin infection at the injection site), history of post-thoracotomy, chest wall deformity, severe uncontrolled comorbidity, intubated patients, or if the interventional physician wants general anaesthesia from the start

Study Plan

How is the study designed?

Design Details

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

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Active Comparator: 50 patients will receive two levels of ultrasound-guided erector spinae plane block (ESPB) at T5 an	Procedure: ultrasound-guided erector spinae plane block in medical pleuroscopy; On the lateral decubitus position, under full aseptic technique; a high frequency (5-13 MHz) linear probe (or curvilinear in obese patients) of ultrasound covered sterilely will be placed in a parasagittal longitudinal orientation approximately 3 cm lateral to the spinous process to identify the trapezius, rhomboid major (if present), erector spinae muscle and thehyperechoic transverse process with its acoustic shadow, with the target being the fascial plane deep to the erector spinae muscle and superficial to the transverse process; the needle will be inserted in-plane in a cranial-to-caudal direction under real-time ultrasound guidance until it contacts the transverse process, after which 1-3 ml of normal saline is injected to confirm correct plane by lifting the erector spinae muscle off the transverse process, then following negative aspiration 20 ml of 0.25% bupivacaine at each level (10 ml 0.5% bupivacaine + 10 ml normal saline ) will be injected incrementally
Active Comparator: patients will receive intracavitary anaesthesia ICA with total volume 40 ml, 20 ml of 0.25% bu	Procedure: Intracavitary anaesthesia ICA; After skin infiltration with lidocaine 2%, at the entry point of the trocar, small (2-4 cm) skin incision in the chest wall will be done, A trocar will be introduced into the pleural cavity. If necessary, air is introduced to allow the lung to collapse, creating space to view the pleural surface. The thoracoscope will be inserted to visualize the pleura. The interventional pulmonologist will receive the pre-prepared syringe from the block anaesthetist and will administer the solution intracavitarily via the thoracoscope working channel, without knowledge of its contents. In both groups, a total volume of 40 mL of solution is administered: 20 mL is sprayed over the costal, diaphragmatic, and mediastinal pleura via the thoracoscope working channel, and an additional 20 mL is injected through the chest tube inserted at the end of the procedure , 10-mL normal saline flush, and the chest tube is then clamped for 5 minutes

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Time Frame
The primary aim: is to compare the effect of US guided ESP block at two levels versus intracavitary blockade in medical thoracoscopy on total peri procedural nalbuphine (mg) consumption during medical thoracoscopy	intraoperative and post-operative 12 hours

Collaborators and Investigators

• Sponsor: Kafrelsheikh University

Study record dates

Study Major Dates

• Study Start (Estimated): May 15, 2026
• Primary Completion (Estimated): July 15, 2026
• Study Completion (Estimated): July 20, 2026

Study Registration Dates

• First Submitted: April 30, 2026
• First Submitted That Met QC Criteria: April 30, 2026
• First Posted (Actual): May 7, 2026

Study Record Updates

• Last Update Posted (Actual): May 12, 2026
• Last Update Submitted That Met QC Criteria: May 7, 2026
• Last Verified: April 1, 2026

More Information

Terms related to this study

• Other Study ID Numbers: Medical pleuroscopy

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No