Erector spinae plane block versus thoracoscopic intercostal nerve block for pain after VATS lung surgery
Prospective, Randomized Comparative Study of an Anesthesiological, Ultrasound-Guided "Erector Spinae Plane Block" (ESPB) Versus a Surgical, Thoracoscopically-Guided "Intercostal Nerve Block" (ICNB) in "Video-Assisted Thoracoscopic" (VATS) Procedures, Evaluating Postoperative Analgesic Consumption, Postoperative Pain Perception, and Duration of the Procedure
This compares two nerve-block techniques to see which gives better pain control after elective VATS lung surgery in adults.
Quick facts
| Phase | Not applicable |
|---|---|
| Study type | Interventional |
| Enrollment | 72 (estimated) |
| Ages | 18 Years and up |
| Sex | All |
| Sponsor | Sana Klinikum Offenbach Academic / other |
| Locations | 1 site (Offenbach, Hesse) |
| Trial ID | NCT07535697 on ClinicalTrials.gov |
What this trial studies
This single-center, prospective, randomized non-inferiority trial randomizes adults having elective VATS lung resections to receive either an ultrasound-guided erector spinae plane block (ESPB) performed by an anesthesiologist before anesthesia induction or a thoracoscopically-guided intercostal nerve block (ICNB) performed by the surgeon intraoperatively. Both groups receive a standardized dose of 25 mL ropivacaine 0.375% and standardized perioperative anesthesia and analgesia protocols. Primary outcomes include postoperative analgesic consumption and pain scores in the first 24 hours after surgery, with secondary monitoring for complications and pulmonary outcomes. Participants are screened to exclude chronic pain, chronic opioid or substance use, coagulopathy, recent chest surgery, pregnancy, and other factors that could affect safety or assessment.
Who should consider this trial
Good fit: Adults aged 18 or older scheduled for elective VATS pulmonary resection (lobectomy, segmentectomy, wedge) who can give informed consent and do not have contraindications to regional anesthesia are ideal candidates.
Not a fit: People with chronic opioid use or chronic pain syndromes, active coagulopathy or ongoing therapeutic anticoagulation, recent chest surgery or intraoperative conversion to open thoracotomy, pregnancy, or inability to consent are unlikely to benefit from the trial results or to be eligible.
Why it matters
Potential benefit: If one technique provides better pain control it could lower opioid needs, improve breathing and coughing, and reduce pulmonary complications after VATS.
How similar studies have performed: Both ESPB and ICNB have demonstrated reductions in postoperative pain and opioid use in prior studies, but direct comparisons have been limited and results across studies have been inconsistent.
Eligibility criteria
Show full inclusion / exclusion criteria
Inclusion Criteria: * Provision of written informed consent * Adults (≥ 18 years of age) * Elective video-assisted thoracoscopic surgery (VATS) for pulmonary resection (e.g., lobectomy, segmentectomy, wedge resection) Exclusion Criteria: * Lack of informed consent * Language barrier * Pregnancy or breastfeeding * Known allergy to local anesthetics used in the study * Infection at the injection site(s) * History of complex chest wall surgery * Revision surgery with a prior operation within the last 6 months * Intraoperative conversion to open thoracotomy * Chronic pain syndrome * Fibromyalgia * Chronic opioid use * Chronic alcohol abuse * Chronic substance abuse (e.g., THC, amphetamines, cocaine) * History of psychiatric disorders (e.g., depression, schizophrenia) * Impaired consciousness, cognition, or ability to communicate * Known coagulopathy (including platelet count \< 80,000/µL or prolonged PTT/aPTT \>1.5× the upper limit of normal) * Ongoing therapeutic anticoagulation
Where this trial is running
Offenbach, Hesse
- Sana Klinikum Offenbach — Offenbach, Hesse, Germany (Recruiting)
Study contacts
- Principal investigator: Haitham Mutlak, Prof. Dr. — Department of Anesthesiology, Intensive Care Medicine and Pain Therapy at Sana Klinikum Offenbach
- Study coordinator: Prof. Dr. H. Mutlak
- Email: haitham.mutlak@sana.de
- Phone: 0049-69-8405-3802
How to participate
- Review the eligibility criteria above with your treating physician.
- Visit the official trial page on ClinicalTrials.gov for the most current contact information and recruitment status.
- Contact the listed study coordinator or principal investigator to request pre-screening. Pre-screening is free and never obligates you to enroll.