Using a paravertebral block during thoracic (VATS/RATS) surgery to reduce postoperative complications

Perioperative Paravertebral Block Reduces Postoperative Complications in Thoracic Surgery: An Observational Study

This study will try an intraoperative paravertebral block to see if it lowers postoperative complications in adults having VATS or RATS for lung or mediastinal procedures.

Quick facts

• Phase: Not applicable
• Study type: Interventional
• Enrollment: 500 (estimated)
• Ages: 18 Years to 80 Years
• Sex: All
• Sponsor: Tongji Hospital (Academic / other)
• Locations: 1 site (Wuhan, Hubei)
• Trial ID: NCT07211529 on ClinicalTrials.gov

What this trial studies

This is an observational study with retrospective and prospective components conducted at Tongji Hospital campuses, focusing on patients undergoing thoracic operations such as wedge resection, segmentectomy, lobectomy, or mediastinal surgery. Retrospectively, prior cases in which an intraoperative paravertebral block (PVB) was used will be analyzed for associations with postoperative complications. Prospectively, perioperative biomarkers (including MMP3, neutrophils, leukocytes, PCT, CRP) and clinical measures (pain and cough scores, time to first flatus and defecation) will be collected, with 30-day follow-up for postoperative complications. The study will correlate biochemical markers with clinical outcomes to explore potential prognostic relationships.

Who should consider this trial

Good fit: Adults aged 18 or older scheduled for VATS or RATS (wedge resection, segmentectomy, lobectomy, or mediastinal surgery) who can give informed consent and are treated by anesthesiologists trained in ultrasound-guided PVB.

Not a fit: Patients converted to open thoracotomy, with prior ipsilateral thoracic surgery, who do not complete the planned surgery, or who are lost to follow-up are unlikely to receive benefit from participation or from study findings.

Why it matters

Potential benefit: If successful, using intraoperative paravertebral block could reduce postoperative complications and speed recovery after thoracic minimally invasive surgery.

How similar studies have performed: Prior randomized and observational studies have shown PVB reduces postoperative pain and opioid use and some suggest fewer pulmonary complications, but results vary and definitive evidence on complication reduction is still limited.

Eligibility criteria

Inclusion Criteria:

1. Male or female participants aged 18 years or older.
2. Scheduled to undergo thoracic surgery via Video-Assisted Thoracoscopic Surgery (VATS) or Robotic-Assisted Thoracoscopic Surgery (RATS), including wedge resection, segmentectomy, lobectomy, or mediastinal surgery.
3. Signed informed consent obtained prior to study participation. -

Exclusion Criteria:

1. Patients who refuse to provide informed consent.
2. Anesthesiologists who have not received training in ultrasound-guided paravertebral block (PVB-US).
3. History of ipsilateral thoracic surgery.
4. Conversion to open thoracotomy during the procedure.
5. Patients who did not complete the scheduled surgery due to disease progression or medical reasons.
6. Patients who are lost to follow-up or refuse postoperative follow-up. -

Where this trial is running

Wuhan, Hubei

• Tongji Medical College of HUST: Huazhong University of Science and Technology Tongji Medical College Tongji Hospital — Wuhan, Hubei, China (Recruiting)

Study contacts

• Principal investigator: Zhang qin Zhang — Huazhong keji daxue tongji yixue yuan fushu tongji yiyuan
• Study coordinator: Guo jiateng Guo

Conditions Video-assisted Thoracoscopic Surgery; Lung Cancer; Pulmonary Infections; Respiratory Failure Without Hypercapnia; Pleural Effusion Due to Another Disorder; Atelectasis; Bronchospasm; Pneumothorax