Subtransverse Process Interligamentary Plane Block Versus Rhomboid Intercostal Block Combined With Sub-Serratus Plane Block for Analgesia in Pediatric Thoracotomy

June 18, 2026 updated by: Walaa Adel Elbialy, Tanta University

Ultrasound- Guided Subtransverse Process Interligamentary Plane Block Versus Rhomboid Intercostal Block Combined With Sub-Serratus Plane Block for Analgesia in Pediatric Thoracotomy: A Randomized Controlled Study

This study aims to compare ultrasound guided subtransverse process interligamentary plane block versus rhomboid intercostal block combined with sub-serratus plane block for postoperative analgesia in pediatric thoracotomy.

Study Overview

Status

Recruiting

Conditions

Intervention / Treatment

Detailed Description

Post-thoracotomy pain is one of the most severe types of pain on the first day of the surgery. In pediatric patients, inadequate analgesia may lead to adverse circulatory and respiratory compromise.

The subtransverse process interligamentary (STIL) plane block is a recently introduced technique that offers a safer alternative by targeting thoracic nerves without entering the paravertebral space.

Recently, some studies have shown that the rhomboid intercostal block (RIB) and the RIB combined with the sub-serratus plane block (RISS) can provide good analgesia effects after video assisted thoracoscope.

Study Type

Interventional

Enrollment (Estimated)

75

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

  • Egypt
    • El-Gharbia
      • Tanta, El-Gharbia, Egypt, 31527
        • Recruiting
        • Tanta University
        • Sub-Investigator:
          • Mohammed S Elsharkawy, MD
        • Sub-Investigator:
          • Naglaa K Mohamed, MD
        • Contact:
        • Sub-Investigator:
          • Lobna M AboAlnassr, MD
        • Sub-Investigator:
          • Mohamed A Lotfy, MD

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

  • Child

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  • Pediatric patients between 6 to 12 years.
  • Both sexes.
  • American Society of Anesthesiologists (ASA) Physical Status I - II.
  • Scheduled for thoracic surgery with thoracotomy incision under general anesthesia.

Exclusion Criteria:

  • Parents who refused regional anesthesia.
  • Patients were presented with advanced kidney, cardiac or liver diseases.
  • Coagulation and bleeding disorders.
  • Patients presented with skin or soft tissue infection at the proposed site of needle Insertion.
  • Patients with cognitive impairment.

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: Control Group
Patients will receive no block intervention and standard intravenous analgesia will be given.
Other: Standard intravenous analgesia
Patients will receive no block intervention and standard intravenous analgesia will be given.
Experimental: STIL block
Patients will receive ipsilateral ultrasound-guided subtransverse process interligamentary (STIL) plane block with bupivacaine 0.25% (0.5 mL/kg) after induction of general anesthesia.
Other: Subtransverse process interligamentary plane block
Patients will receive ipsilateral ultrasound-guided subtransverse process interligamentary (STIL) plane block with bupivacaine 0.25% (0.5 mL/kg) after induction of general anesthesia.
Experimental: RISS block group
Patients will receive ipsilateral ultrasound-guided rhomboid intercostal block (RIB) combined with sub-serratus plan block group with bupivacaine 0.25% (0.5mL/kg) after induction of general anesthesia.
Other: Rhomboid intercostal block (RIB) combined with sub-serratus plan block group
Patients will receive ipsilateral ultrasound-guided rhomboid intercostal block (RIB) combined with sub-serratus plan block group with bupivacaine 0.25% (0.5mL/kg) after induction of general anesthesia.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Time to first rescue analgesia
Time Frame: 24 hours postoperatively
Time to the first rescue analgesia will be recorded from the end of surgery till first dose of morphine adminstrated.
24 hours postoperatively

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Degree of pain
Time Frame: 24 hours postoperatively
Each patient will be instructed about postoperative pain assessment with VAS. VAS (0 represents "no pain" while 10 represents "the worst pain imaginable"). VAS will be assessed after surgery over 24 hours (30 minutes postoperative, 2, 4, 6, 12, 24 hours.
24 hours postoperatively
Total Opioids consumption
Time Frame: 24 hours postoperatively
Morphine 0.05 mg /kg IV will be given as rescue analgesia if VAS score ≥4, morphine dose will not exceed 0.3 mg/kg/day.
24 hours postoperatively
Intraoperative fentanyl consumption
Time Frame: Intraoperatively
Fentanyl 0.5 μg/kg will be administrated in the case of inadequate analgesia that defined as an un explained increase of heart rate (HR) and/or mean arterial blood pressure (MAP) more than 20% above the preoperative values after exclusion of other causes.
Intraoperatively

Collaborators and Investigators

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

Sponsor

Tanta University

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)

September 1, 2025

Primary Completion (Estimated)

September 1, 2027

Study Completion (Estimated)

September 1, 2027

Study Registration Dates

First Submitted

June 18, 2026

First Submitted That Met QC Criteria

June 18, 2026

First Posted (Actual)

June 24, 2026

Study Record Updates

Last Update Posted (Actual)

June 24, 2026

Last Update Submitted That Met QC Criteria

June 18, 2026

Last Verified

June 1, 2026

More Information

Terms related to this study

Additional Relevant MeSH Terms

Other Study ID Numbers

  • 36265MD454/8/25

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.

Clinical Trials on Analgesia

Clinical Trials on Standard intravenous analgesia

Search Similar Trials

Sponsors and Collaborators

Medical Conditions

Drug Interventions

CROs by country

CROs in Ethiopia

Conditions

Rare Diseases

Drug Interventions

Dietary Supplements

Sponsor/Collaborators

Locations

3
Subscribe