Erector Spinae Plane Block Versus Serratus Anterior Plane Block in VATS
For patients and families
In plain language
An automatic summary of structured registry data. It is an orientation aid, not a substitute for the official protocol or a physician assessment.
- What is being studied
- The protocol lists: Erector Spinae Plane Block (ESPB) group, Serratus Anterior Plane Block (SAPB) group.
- Who it may be relevant to
- Registry conditions: Video Assisted Thoracic Surgery (VATS). Basic parameters: 18 years — 70 years · All.
- What needs checking
- Age, condition and sex are only basic indicators. Prior treatment, laboratory values and other mandatory requirements appear in the eligibility criteria below.
- Where it takes place
- Egypt
- Next step
- Save the trial, show it to the treating physician, and confirm current recruitment with the study center. Costs, documents and travel →
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Official title
A Comparative Study of Erector Spinae Plane Block Versus Serratus Anterior Plane Block for Postoperative Analgesia After Video-assisted Thoracoscopic Surgery
Overview
Pain control remains challenging in patients undergoing video-assisted thoracoscopic surgery (VATS). It is advised to use a regional block to lower postoperative opioid usage. This study evaluates efficacy of Erector spinae plane (ESP) block in comparison to Serratus anterior plane block (SAP) in pain management for patients undergoing video-assisted thoracoscopic surgery(VATS).
Detailed description
Minimally invasive thoracic surgery (MITS) has become more common over the past decade, with the proportion of lung resections performed using this technique increasing from 16% in 2005 to 47% in 2015.
VATS is a minimally invasive procedure that allows rapid recovery compared to thoracic surgery. Patients scheduled for VATS experience moderate to severe pain following the procedure. This represents a significant burden peri-operatively as there is a strong relationship between poor pain control and the development of complications like pneumonia and atelectasis due to interference with spontaneous deep breathing \& coughing. These complications have a negative impact on functional recovery; therefore, adequate postoperative pain relief assists in improving functional outcomes \& accelerates hospital discharge.
Multimodal techniques for pain control have been recommended by The American Society of Anesthesiologists (ASA) for the management of acute postoperative pain. Traditional analgesia based on opioids have multiple adverse effects such as respiratory depression, nausea, vomiting, itching and dizziness.
SAP block was first described in 2013 by Blanco as an analgesic technique.it is proposed to block the lateral cutaneous branch of the intercostal nerve, long thoracic nerve, and dorsal thoracic nerve. The block range of the SAPB covers the incisions of video-assisted thoracoscopic surgery (VATS) and the site of the chest tube, which are often located in the antero-lateral chest wall. The local anaesthetic injection was described in two planes: the 'superficial plane' and deep plane.
An ultrasound-guided ESP block was firstly reported in 2016. The ESP block injects a local anaesthetic around the erector spinae muscle at approximately the level of the T5. It may be able to block the dorsal and ventral rami of the thoracic spinal nerves. The first report of the successful use of this procedure was in 2016; the block was used to manage thoracic neuropathic pain in a patient with metastatic disease of the ribs and rib fractures
Interventions
- Procedure Erector Spinae Plane Block (ESPB) group
30ml of 0.25% levobupivacaine for erector spinae block at level of T5 - Procedure Serratus Anterior Plane Block (SAPB) group
30 mL of 0.25% levobupivacaine injected anteriorly to the rib and deep to the serratus anterior at level of 5 th rib
Primary outcome measures
- post operative opioid consumption [Time frame: 24 hours post operative]
Secondary outcome measures (2)
- intraoperative fentanyl consumption [Time frame: during the surgery]
- the numerical rating scale [Time frame: 24 hours post operative]
Eligibility criteria
Inclusion criteria
- body mass index (BMI)=18 to 40 kg/m2
Exclusion criteria
- Contraindications to regional anesthesia as bleeding disorders , allergy to local anesthetic or infection at block site
- pre-existing chronic pain
- history of opiate abuse
- sepsis
Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.
Healthy volunteers: No
Study design
- Allocation
- Randomized
- Model
- Parallel assignment
- Masking
- Double blind
- Primary purpose
- Treatment
Study locations
Egypt · 1 center
- faculty of medicine Ain Shams University — Cairo
Identifiers
NCT: NCT06996691 · FMASU MS 145/2025