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Comparison of Liposomal Bupivacaine Paravertebral Nerve Block Versus Intercostal Nerve Block on Postoperative Glycemic Variability in Patients Undergoing Minimally Invasive Pulmonary Resection: A Randomized Controlled Non-Inferiority Trial

9. august 2026 oppdatert av: Xiangya Hospital of Central South University
In this randomized controlled non-inferiority trial, we will test whether liposomal bupivacaine intercostal nerve block is non-inferior to paravertebral nerve block for the coefficient of variation (CV) of glucose during the 0- to 48-hour postoperative period, using a non-inferiority margin of Δ = 0.025 for the absolute CV difference. We will also compare the two blocks regarding their effects on postoperative glucose, autonomic function, stress, insulin resistance, acute pain, recovery quality, procedure duration, complications, and hemodynamic stability.

Studieoversikt

Status

Har ikke rekruttert ennå

Forhold

Intervensjon / Behandling

Studietype

Intervensjonell

Registrering (Antatt)

64

Fase

  • Ikke aktuelt

Kontakter og plasseringer

Denne delen inneholder kontaktinformasjon for de som utfører studien, og informasjon om hvor denne studien blir utført.

Studiekontakt

Studer Kontakt Backup

Studiesteder

  • Kina
    • Hunan
      • Changsha, Hunan, Kina, 410000
        • Department of Anesthesiology, Xiangya Hospital, Central South University
        • Ta kontakt med:
        • Ta kontakt med:

Deltakelseskriterier

Forskere ser etter personer som passer til en bestemt beskrivelse, kalt kvalifikasjonskriterier. Noen eksempler på disse kriteriene er en persons generelle helsetilstand eller tidligere behandlinger.

Kvalifikasjonskriterier

Alder som er kvalifisert for studier

  • Voksen
  • Eldre voksen

Tar imot friske frivillige

Nei

Beskrivelse

Inclusion Criteria:

  1. Aged 18-70 years, with American Society of Anesthesiologists (ASA) physical status I-III, scheduled for uniportal or multiportal video-assisted thoracoscopic (VATS) minimally invasive pulmonary resection under general anesthesia.
  2. Planned to receive liposomal bupivacaine regional block analgesia under direct thoracoscopic visualization.
  3. Body mass index (BMI) 18-30 kg/m².
  4. Willing and able to cooperate with the study procedures and provide written informed consent.

Exclusion Criteria:

  1. Regularly taking beta-blockers (for ≥2 weeks) or long-term use of high-dose glucocorticoids (prednisone ≥20 mg/day for >2 weeks).
  2. Known history of diabetes mellitus, or regular use of glucose-lowering agents (oral agents or insulin) before surgery.
  3. Planned postoperative admission to the intensive care unit (ICU).
  4. Concurrent severe cardiac (New York Heart Association class III or higher), hepatic (e.g., cirrhosis), or renal insufficiency (glomerular filtration rate <30 mL/min/1.73 m²), or neuropsychiatric disorders.
  5. Contraindications to regional block or to any study medication, including but not limited to infection or tumor invasion at the puncture site, coagulation disorders, or allergy to any drug used in the study.
  6. Alcohol dependence: meeting the DSM-5 criteria for severe alcohol use disorder (AUD), or clinically judged as alcohol dependence (regardless of liver function status).
  7. Pregnancy or lactation (for men and women of childbearing potential, effective contraception is required until 3 months after surgery, and donation of sperm or eggs is prohibited).
  8. Participation in another interventional drug trial.
  9. Regular use of analgesics for acute or chronic pain within 2 weeks before surgery.
  10. Concurrent severe infection.
  11. Prior ipsilateral intrathoracic surgery or severe pleural adhesions (estimated to preclude successful thoracoscopic visualization and completion of the block).
  12. Psychiatric or cognitive disorders that would impair the ability to cooperate with postoperative follow-up.
  13. Any other condition that, in the investigator's judgment, would make the patient unsuitable for participation in the trial (for medical or safety reasons).

Studieplan

Denne delen gir detaljer om studieplanen, inkludert hvordan studien er utformet og hva studien måler.

Hvordan er studiet utformet?

Designdetaljer

  • Primært formål: Behandling
  • Tildeling: Randomisert
  • Intervensjonsmodell: Parallell tildeling
  • Masking: Dobbelt

Våpen og intervensjoner

Deltakergruppe / Arm
Intervensjon / Behandling
Aktiv komparator: kontrollgruppe
Fremgangsmåte: Intercostal nerve block
Following induction of general anesthesia, the surgeon will perform thoracoscopic intercostal nerve blocks using liposomal bupivacaine (prepared as 20 mL of 6.65 mg/mL solution diluted with 20 mL normal saline to 40 mL total) to cover the surgical incision and pleural irritation areas, typically at the 3rd-8th intercostal spaces. Under direct vision, 4.0 mL of the diluted solution will be injected at each space at a site 3-5 cm lateral to the spine, for a total liposomal bupivacaine dose of 159.6 mg (24 mL). Injections will be slow and fractionated, with aspiration for blood or CSF before each injection, and care will be taken to prevent overdose and systemic toxicity.
Eksperimentell: behandlingsgruppe
Fremgangsmåte: Paravertebral nerve block
Following induction of general anesthesia, a T3-T8 paravertebral nerve block will be performed by the surgeon under thoracoscopic guidance. Liposomal bupivacaine (6.65 mg/mL) will be diluted with normal saline (20 mL + 20 mL = 40 mL total). Under direct vision, 4.0 mL of the diluted solution will be injected evenly at each level, lateral to the sympathetic chain, for a total liposomal bupivacaine dose of 159.6 mg (24 mL). Injections will be slow and fractionated, with aspiration for blood or cerebrospinal fluid prior to each injection, and care will be taken to prevent overdose and systemic toxicity.

Hva måler studien?

Primære resultatmål

Resultatmål
Tidsramme
Coefficient of Variation of Blood Glucose
Tidsramme: 48 hours post-surgery
48 hours post-surgery

Sekundære resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
Glycated Serum Protein (GSP)
Tidsramme: Preoperatively and on the first postoperative day
Preoperatively and on the first postoperative day
Heart Rate Variability
Tidsramme: Preoperatively and on the first postoperative day, the second postoperative day, and the third postoperative day
Preoperatively and on the first postoperative day, the second postoperative day, and the third postoperative day
Fasting Serum Insulin
Tidsramme: Preoperatively and on the first postoperative day
Preoperatively and on the first postoperative day
Numerical Rating Scale (NRS) Pain Score
Tidsramme: Preoperatively and on the first postoperative day, the second postoperative day, and the third postoperative day
Numerical Rating Scale (NRS) Pain Score Scale range: 0 (no pain) to 10 (worst imaginable pain). Higher scores indicate more severe pain.
Preoperatively and on the first postoperative day, the second postoperative day, and the third postoperative day
Fasting C peptide
Tidsramme: Preoperatively and on the first postoperative day
Serum fasting C-peptide concentration measured by chemiluminescent immunoassay
Preoperatively and on the first postoperative day
Cortisol
Tidsramme: Preoperatively and on the first postoperative day
Serum cortisol concentration measured by chemiluminescent immunoassay
Preoperatively and on the first postoperative day

Samarbeidspartnere og etterforskere

Det er her du vil finne personer og organisasjoner som er involvert i denne studien.

Sponsor

Xiangya Hospital of Central South University

Etterforskere

  • Hovedetterforsker: Yingqi Weng, MD, Department of Anesthesiology, Xiangya Hospital, Central South University

Studierekorddatoer

Disse datoene sporer fremdriften for innsending av studieposter og sammendragsresultater til ClinicalTrials.gov. Studieposter og rapporterte resultater gjennomgås av National Library of Medicine (NLM) for å sikre at de oppfyller spesifikke kvalitetskontrollstandarder før de legges ut på det offentlige nettstedet.

Studer hoveddatoer

Studiestart (Antatt)

1. august 2026

Primær fullføring (Antatt)

1. februar 2027

Studiet fullført (Antatt)

28. februar 2027

Datoer for studieregistrering

Først innsendt

28. juli 2026

Først innsendt som oppfylte QC-kriteriene

4. august 2026

Først lagt ut (Faktiske)

10. august 2026

Oppdateringer av studieposter

Sist oppdatering lagt ut (Faktiske)

12. august 2026

Siste oppdatering sendt inn som oppfylte QC-kriteriene

9. august 2026

Sist bekreftet

1. juli 2026

Mer informasjon

Begreper knyttet til denne studien

Andre studie-ID-numre

  • Ethics Approval No. 202606086

Plan for individuelle deltakerdata (IPD)

Planlegger du å dele individuelle deltakerdata (IPD)?

NEI

IPD-planbeskrivelse

Individual participant data will not be shared externally. All raw data are restricted to the research team to protect participants' privacy. Data sharing plans have not been established at this stage.

Legemiddel- og utstyrsinformasjon, studiedokumenter

Studerer et amerikansk FDA-regulert medikamentprodukt

Nei

Studerer et amerikansk FDA-regulert enhetsprodukt

Nei

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