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Uniportal Video-assisted Thoracic SurgeryNCT06016777

Optimization of Perioperative Analgesia Protocol for Uniportal Video-assisted Thoracoscopic Surgery

A study of Uniportal Video-assisted Thoracic Surgery, run by China-Japan Friendship Hospital at 1 site in China.

Unknown status

Status not confirmed. The sponsor has not verified this record for over two years, so it may be out of date.

Official record
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Trial summary

Trial design Despite video-assisted thoracic technology and procedure specific postoperative pain management (PROSPECT) have been promoted through recent years, thoracic surgery is still considered to be one of the most painful of surgical procedures. Read more about this study

Who is it for?
Ages 18 years and older
Could I receive a placebo?
No, everyone receives an active treatment
How many people
102 participants
Where
1 siteChina
Study dates
10 Oct 2023to 31 Oct 2025
Phase
Interventional
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • ≥18 years
  • ASA I-IIa
  • Early stage lung cancer or intrathoracic tissue biopsy, suitable for elective uVATSb
  • Informed consent obtained

Who cannot join

  • ASA≥III
  • History of intrathoracic or chest wall surgery
  • Chronic pain
  • Pre-operative analgesic medication use
  • NSAIDsc contraindications: aspirin asthma, allergic to NSAIDs, peptic ulcer, liver and kidney insufficiency, high risk of thrombotic events
  • Active autoimmune disease
Show all 9Show fewer
  • Allergic to local anesthetics
  • Severe coagulation dysfunction, contraindicated for nerve block
  • Soft tissue infections of the chest wall

Trial locations and contacts

1 site in 1 country.

Li Fang WANG, Doctor contact

+8615011393879

lilythewolf@sina.com

Zhen Rong ZHANG, Doctor contact

+8613811000378

doctor_zzr@126.com

China1 site, 1 recruiting
  • China-Japan Friendship Hospital

    Beijing, Beijing Municipality, 100029

    Li Fang Wang, MD

    Recruiting

Other trials in China

About this study

Official title: Optimization of Perioperative Analgesia Protocol for Uniportal Video-assisted Thoracoscopic Surgery: a Randomized Controlled Trial

Trial design Despite video-assisted thoracic technology and procedure specific postoperative pain management (PROSPECT) have been promoted through recent years, thoracic surgery is still considered to be one of the most painful of surgical procedures. This study aims to optimize these conditions according to different perioperative analgesic modes recommended at present. This will be a single-blind randomized study to investigate the optimal analgesic effect of thoracic paravertebral block (TPB), erector spinae block (ESB), or sufentanil patient controlled intravenous analgesia (PCIA) for uniportal video-assisted thoracoscopic surgery (uVATS) and using minimally invasive drainage.

Methods One-hundred and two patients undergoing uVATS will be enrolled. Patients will be randomly assigned to PVB group (20mL 0.3% ropivacaine with dexamethasone), ESB group (20mL 0.3% ropivacaine with dexamethasone) or CON group. PCIA with sufentanil will be provided to all patients after surgery. Primary outcome will be total opioid consumption from the end of the surgery to the time of discharge. Secondary outcomes consist of postoperative pain score, postoperative chronic pain, both at rest and during coughing, sensations of touch and pain on the chest wall, non-opioid analgesic drug use, length of stay (LOS), ambulation time, total cost of hospitalization and long-term postoperative analgesia. Adverse reaction to analgesics and adverse event related to regional block will also be recorded.

Read more

Ethics and dissenmination This study is approved by the Ethics Committee of China-Japan Friendship Hospital (ID 2022-KY-127-1). The results will be published in peer-reviewed journals.

Key words: fast-track; Enhanced Recovery After Surgery; uniportal video-assisted thoracoscopic surgery; randomized controlled trial; thoracoscopic; ultrasonic guidance; paravertebral block; erector spinal block

Read the detailed description

This is a prospective, randomized controlled study. Patients who are scheduled for elective uniportal thoracoscopic surgery in our hospital will be enrolled. Patients will be randomly assigned to one of the three groups: ultrasound-guided paravertebral block, ultrasound-guided erector spinae block, or intravenous patient-controlled analgesia pump group. Different nerve block operation schemes will be used in different groups.

In any of the three groups, general anesthesia will be performed according to the standard, and multi-mode analgesic treatment will be appied as the combination of NSAIDs analgesics, opioid analgesics, and postoperative rescue analgesic treatment. Participants will be followed up at 1, 4, 12, 18 hours, on 1, 2, 3, 4, 7 days, and in 1, 2, 3, 4, 6 months after surgery. At each follow-up visit, rest and cough pain level will be recorded, and sense of touch and pain in the chest will be examined. Additional analgesic treatment will be given if necessary.

Comparisons of the postoperative analgesic use, cough and rest pain, ambulation time, length of hospital stay, and hospital costs will be made in the three groups.

Being tested
Ultrasound-guided paraspinal block and patient-controlled intravenous analgesia pump, Ultrasound-guided erector spinal block and patient-controlled intravenous analgesia pump, Patient-controlled intravenous analgesia pump
Keywords
fast-track, Enhanced Recovery After Surgery, uniportal video-assisted thoracoscopic surgery, randomized controlled trial, thoracoscopic; ultrasonic guidance, paravertebral block, erector spinal block

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Ultrasound-guided paraspinal block and patient-controlled intravenous analgesia pumpProcedure or surgery

    Patients in this group will receive ultrasound-guided paraspinal block with 0.3% ropivacaine and 5mg dexamethasone in total of 20mL saline at T5 level on the operative side. Patients in all the groups will be treated with PCIA after surgery. PCIA with sufentanil will be applied to all participants, with background infusion at 1.8μg/hour, and total dosage <5μg/hour.

  • Ultrasound-guided erector spinal block and patient-controlled intravenous analgesia pumpProcedure or surgery

    Patients in this group will receive ultrasound-guided erector spinal block with 0.3% ropivacaine and 5mg dexamethasone in total of 20mL saline at T5 level on the operative side. Patients in all the groups will be treated with PCIA after surgery. PCIA with sufentanil will be applied to all participants, with background infusion at 1.8μg/hour, and total dosage <5μg/hour.

  • Patient-controlled intravenous analgesia pumpProcedure or surgery

    Patients in this group will not receive regional block. Patients in all the groups will be treated with PCIA after surgery. PCIA with sufentanil will be applied to all participants, with background infusion at 1.8μg/hour, and total dosage <5μg/hour.

Study groups in NCT06016777
Study groupRoleWhat they receive
PVB+PCIA groupExperimentalNot described
Receives: Procedure: Ultrasound-guided paraspinal block and patient-controlled intravenous analgesia pump; Procedure: Patient-controlled intravenous analgesia pump
ESB+PCIA groupExperimentalNot described
Receives: Procedure: Ultrasound-guided erector spinal block and patient-controlled intravenous analgesia pump; Procedure: Patient-controlled intravenous analgesia pump
PCIA groupActive comparatorNot described
Receives: Procedure: Patient-controlled intravenous analgesia pump

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. total opioid consumption

    total opioid (morphine equivalent/body weight) consumption from the end of the surgery to the time of discharge.

    Measured: up to 6 months, total opioid use from postoperative period till the discontinuation of surgery-related therapy.

Secondary outcomes (10)
  1. postoperative pain score assessed by Visual Analogue Scale VAS (1-10)

    rest and cough pain

    Measured: from the time at the end of surgery to 24 weeks after surgery

  2. postoperative pain score assessed by Numeric Rating Scales, NRS (1-10)

    rest and cough pain

    Measured: from the time at the end of surgery to 24 weeks after surgery

  3. sensations of touch on the chest wall

    difference in tactile sense on bilateral chest-wall. Tactile sensation and cold sensation will be measured at four points (<3cm near the incision, and on the other side on the symmetrical chest wall, and at the point of bilateral mid-clavicular-costal arch) with an alcohol-stained cotton swab

    Measured: from the time at the end of surgery to 24 weeks after surgery

  4. non-opioid analgesic drug use

    number of patients with long-term (≥3 days) use of non-opioid analgesic drug

    Measured: from the time at the end of surgery to 24 weeks after surgery

  5. length of stay (LOS)

    days of hospital stay

    Measured: up to 1 month, LOS is the amount of days the patient spends in the hospital, determined by subtracting the date of admission from the date of discharge

  6. ambulation time

    first time of successful activity off bed, the time between the end of surgery to the time of the first successful ambulation

    Measured: up to 1 month, ambulation time is the time the patient first ambulated following the surgical procedure

  7. total cost of hospitalization

    the in-patients costs total cost of hospitalization=medication cost + hospitalization cost + nursing cost + delay compensation

    Measured: up to 1 month, total charges settled on the day of discharge

  8. long-term postoperative analgesia

    number of patient who needs long-term postoperative analgesia (≥3 days after discharge)

    Measured: from the time at the end of surgery to 24 weeks after surgery

  9. adverse events

    Adverse reactions such as dizziness, nausea, vomiting, drowsiness, dyspnea, fatigue, constipation and urinary retention were recorded in detail

    Measured: from the time at the end of surgery to 24 weeks after surgery

  10. chest tube removal time

    The time from surgery to removal of the chest drainage tube

    Measured: from the time at the end of surgery to 24 weeks after surgery

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted30 Aug 2023
  2. Study start10 Oct 2023
  3. Primary completion30 Sep 2025 (estimated)
  4. Study completion31 Oct 2025 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Prevention
Allocation
Randomised
Intervention model
Parallel groups
Model description
This will be a parallel-group, single-blind, randomized controlled trial. Patients are expected to be enrolled in the trial within 8 months. Participants will be randomly assigned to one of the three groups: ultrasound-guided paravertebral block (PVB+PCIA group), ultrasound-guided erector spinae block(ESB+PCIA group) , or intravenous patient-controlled analgesia pump group (PCIA group). Different nerve block operation schemes will be used in different groups.Except for different nerve block schemes, all the participants will have the same methods and choices of medicine for other kinds of rescue analgesia regimens.The participants and the follow-up evaluation doctors are not aware of the group assignment, and the surgeon and anesthesiologist will not know the grouping code until the beginning of the surgery. In this way, the analgesic effect of each subject can be fairly evaluated.
Masking
Triple blind
Who is masked
Participant, Investigator, Outcomes assessor
Enrolment
102 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT06016777
Sponsor's protocol ID
ChinaJapanFHAnesth2
Status last verified
Jan 2024
First submitted
14 Aug 2023
Last updated
29 Jan 2024
Results posted
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Undecided: Security cameras are set up next to both the computer and the cabinet for data storage. The surveillance video will be available only to medical staff and the principal investigator. Access to data will be restricted to authorized personnel, including ethics committee directors, principal investigator and authorized personnel. Access to paper documents as well as electronic data must be registered, with the name of operator and detailed reasons recorded. The results and conclusions of our research will be reported to all the participants, research team, and the public in peer-reviewed journal. The investigators will try to put forward the existing guidelines to further optimization of perioperative anesthesia and analgesia protocol for small-incision thoracic surgery and optimized drainage tube strategy.

Publications

  • Wang LF, Qi F, Feng HX, Shi YH, Li Y, Zheng MT, Bu T, Li WX, Zhang ZR. Risk and benefit analysis of single-shot nerve block for postoperative analgesia for uniportal video-assisted thoracic surgery (uVATS): a randomized controlled trial. BMC Anesthesiol. 2025 Feb 12;25(1):68. doi: 10.1186/s12871-025-02955-w.

    PubMed 39939956
  • Wang LF, Feng HX, Shi YH, Li Y, Zheng MT, Bu T, Zhang ZR. Protocol for a randomised controlled trial: optimisation of perioperative analgesia protocol for uniportal video-assisted thoracoscopic surgery. BMJ Open. 2024 Apr 2;14(4):e079434. doi: 10.1136/bmjopen-2023-079434.

    PubMed 38569709

Questions about this trial

What is this clinical trial studying?

A study of Uniportal Video-assisted Thoracic Surgery, run by China-Japan Friendship Hospital at 1 site in China.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 4 inclusion and 9 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: status not confirmed, as of the sponsor's last update on 29 Jan 2024. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in China. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

Results are not available in the source record.

How can a doctor refer a patient or contact the research team?

Contact Li Fang WANG, Doctor (+8615011393879, lilythewolf@sina.com), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

total opioid consumption (time frame: up to 6 months, total opioid use from postoperative period till the discontinuation of surgery-related therapy.). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT06016777, which also lists 2 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 29 Jan 2024.

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