Comparing three ultrasound-guided nerve blocks to reduce pain after video-assisted thoracic surgery

The Effect of Paravertebral Block, Intertransverse Block, and Erector Spinae Plane Block on Postoperative Opioid Consumption and Pain Scores in Video-assisted Thoracic Surgery: a Prospective Observational Study

This trial will try three ultrasound-guided regional blocks — paravertebral, intertransverse process, and erector spinae plane — to see which best lowers opioid use and pain after elective VATS in adults.

Quick facts

• Study type: Observational
• Enrollment: 96 (estimated)
• Ages: 18 Years to 75 Years
• Sex: All
• Sponsor: Antalya Training and Research Hospital (other gov)
• Locations: 1 site (Antalya, Muratpaşa)
• Trial ID: NCT07578545 on ClinicalTrials.gov

What this trial studies

Researchers will compare three ultrasound-guided regional anaesthesia techniques — paravertebral block, intertransverse process block, and erector spinae plane block — in adults undergoing elective video-assisted thoracic surgery (VATS) at Antalya Training and Research Hospital. The observational study will record postoperative opioid consumption and pain scores, along with recovery metrics related to mobilisation and pulmonary complications. Eligible patients are adults aged 18–75 with ASA I–III and BMI under 35, excluding chronic opioid users and those with contraindications to block application. Outcomes will be compared across the three groups to identify which technique provides better analgesia and lower opioid requirements.

Who should consider this trial

Good fit: Adults aged 18–75 scheduled for elective VATS with ASA I–III and BMI under 35 who can receive ultrasound-guided regional blocks and are not chronic opioid users are ideal candidates.

Not a fit: Patients with contraindications to regional blocks, chronic opioid use, severe liver or kidney failure, ASA ≥4, BMI ≥35, or those who remain intubated in the ICU postoperatively are unlikely to receive benefit from participation.

Why it matters

Potential benefit: If successful, the study could identify a regional block that reduces opioid use and pain after VATS, improving recovery and lowering the risk of pulmonary complications.

How similar studies have performed: Previous studies have shown paravertebral and erector spinae plane blocks can reduce opioid consumption and pain after thoracic surgery, while the intertransverse process block is newer with more limited comparative evidence.

Eligibility criteria

Inclusion Criteria:

* aged 18-75 years
* American Society of Anaesthesiology (ASA) score I-III
* body mass index (BMI) \<35kg/m2
* scheduled for elective VATS

Exclusion Criteria:

* ASA score ≥4
* BMI ≥35 kg/m2
* declining to give written informed consent
* controendications for block application
* inability to undergo block application
* history neurological disease or peripheral nerve disease
* history of chronic opioid use
* history of severe liver or kidney failure
* patients admitted to the intensive care unit postoperatively intubated

Where this trial is running

Antalya, Muratpaşa

• University of Health Sciences, Antalya Training and Research Hospital — Antalya, Muratpaşa, Turkey (Türkiye) (RECRUITING)

Study contacts

• Principal investigator: Sadik Ozmen — University of Health Sciences, Antalya Training and Research Hospital
• Study coordinator: Sadik Ozmen

Conditions: Thoracic Surgery, Videoassisted Thoracoscopic Surgery,One-lung Ventilation, Regional Anaesthesia, Postoperative Analgesia, Pain Score, videoassisted thoracoscopic surgery, regional anaesthesia, postoperative analgesia