Lung CancerRIB-ESPBNCT07040618
Rhomboid Intercostal Block vs Erector Spinae Block
A study testing Ultrasound-guided Rhomboid Intercostal Block and Ultrasound-guided Erector Spinae Plane Block in people with Lung Cancer, run by Cairo University at 1 site in Egypt.
Trial summary
This randomized trial compares rhomboid intercostal block (RIB) and erector spinae plane block (ESPB) for postoperative pain control in lung cancer patients undergoing thoracotomy. Read more about this study
- Who is it for?
- Ages 18 to 65 years
- Conditions the study is for
- Lung Cancer
- What is being tested?
- Ultrasound-guided Rhomboid Intercostal Block and Ultrasound-guided Erector Spinae Plane Block
- Type of treatment
- Injection or infusion, Surgery or procedure
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 60 participants
- Where
- 1 siteEgypt
- Study dates
- 1 Jul 2025to 1 Jan 2027
- Phase
- Interventional
- Are there results?
- Not yet: the study is under way
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 to 65 years
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- patients undergoing thoracotomy for lung cancer
- Age ≥ 18 years and ≤ 65 years
- ASA physical status II or III
- Body Mass Index (BMI) > 20 kg/m² and < 35 kg/m²
- Willing and able to provide informed consent
Who cannot join
- Patient refusal
- ASA physical status IV
- Age < 18 years or > 65 years
- BMI < 20 kg/m² or > 35 kg/m²
- Known allergy or contraindication to local anesthetics or opioids used in the study
- History of chronic pain or psychological disorders
Show all 9Show fewer
- Contraindications to regional anesthesia (e.g., local infection, coagulopathy, pre-existing peripheral neuropathy)
- Severe respiratory, cardiac, hepatic, or renal disease
- -
Trial locations and contacts
1 site in 1 country. Contact the study team or a site near you to ask about taking part.
Egypt1 site, 1 recruiting
- Recruiting
National Cancer Institute - Cairo University
Cairo
About this study
Official title: Assessing the Effectiveness of Rhomboid Intercostal and Erector Spinae Plane Blocks After Lung Cancer Thoracotomy
This randomized trial compares rhomboid intercostal block (RIB) and erector spinae plane block (ESPB) for postoperative pain control in lung cancer patients undergoing thoracotomy. Sixty patients will be assessed for 24-hour morphine consumption, pain scores, hemodynamics, recovery time, satisfaction, and side effects. The study aims to identify the more effective technique for enhancing recovery and minimizing opioid use.
Read the detailed description
This randomized clinical trial aims to evaluate the analgesic efficacy of two ultrasound-guided regional anesthesia techniques-Rhomboid Intercostal Block (RIB) and Erector Spinae Plane Block (ESPB)-in female lung cancer patients undergoing thoracotomy at the National Cancer Institute, Cairo University. Thoracotomy is known for causing severe postoperative pain, which, if not effectively managed, can lead to chronic pain and impaired pulmonary function. Traditional techniques like thoracic epidural or paravertebral blocks, while effective, have limitations due to technical complexity and potential complications. Recently, interfascial plane blocks such as ESPB have shown promise for thoracic analgesia, and RIB has emerged as a technique potentially offering superior lateral thoracic wall coverage.
Sixty patients will be randomly assigned to receive either RIB or ESPB 30-45 minutes before surgery. The primary outcome is 24-hour postoperative morphine consumption. Secondary outcomes include visual analog scale (VAS) pain scores, hemodynamic stability, time to first analgesic request, recovery duration, patient satisfaction, and incidence of nausea and vomiting.
General anesthesia will be standardized across both groups. Data will be analyzed using appropriate statistical tests, and ethical approval will be obtained prior to patient enrollment. This study supports multimodal analgesia and aims to inform clinical practice in pain management after oncologic thoracic surgery.
- Conditions
- Lung Cancer
- Being tested
- Ultrasound-guided Rhomboid Intercostal Block, Ultrasound-guided Erector Spinae Plane Block
- Medical subject headings
- Lung Neoplasms
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Ultrasound-guided Rhomboid Intercostal BlockProcedure or surgery
This intervention involves an ultrasound-guided injection of 20-25 mL of 0.25% bupivacaine into the fascial plane between the rhomboid major and intercostal muscles. The patient is positioned laterally, and the block is performed at the T5-T6 level using a high-frequency linear ultrasound probe. The goal is to anesthetize the lateral cutaneous branches of the intercostal nerves to provide postoperative thoracic analgesia.
Ultrasound-guided Erector Spinae Plane BlockProcedure or surgery
This intervention consists of an ultrasound-guided injection of 20-25 mL of 0.25% bupivacaine into the plane deep to the erector spinae muscle at the T4-T5 transverse process level. The patient is positioned sitting or in lateral decubitus, and the procedure uses a curved or linear ultrasound probe. This block targets the dorsal and ventral rami of thoracic spinal nerves to manage postoperative pain after thoracotomy.
| Study group | Role | What they receive |
|---|---|---|
| Ultrasound-guided Rhomboid Intercostal Block | Experimental | Patients in this group will receive a rhomboid intercostal block with 20-25 mL of 0.25% bupivacaine injected between the rhomboid major and intercostal muscles under ultrasound guidance 30-45 minutes before surgery. Receives: Procedure: Ultrasound-guided Rhomboid Intercostal Block |
| Ultrasound-guided Erector Spinae Plane Block | Active comparator | Patients in this group will receive an erector spinae plane block with 20-25 mL of 0.25% bupivacaine injected deep to the erector spinae muscle at the T4-T5 level under ultrasound guidance 30-45 minutes before surgery. Receives: Procedure: Ultrasound-guided Erector Spinae Plane Block |
What is being measured
The primary outcome is the main question the study is designed to answer.
24-hour postoperative morphine consumption
This outcome measures the total amount of morphine (in milligrams) administered to each patient within the first 24 hours after thoracotomy. Morphine will be given as rescue analgesia when the patient reports a visual analog scale (VAS) pain score of 4 or more. The cumulative dose will be recorded and compared between the Rhomboid Intercostal Block (RIB) and Erector Spinae Plane Block (ESPB) groups to evaluate the relative effectiveness of each regional anesthesia technique in managing postoperative pain.
Measured: Within the first 24 hours postoperatively
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted27 Jun 2025
- Study start1 Jul 2025
- Primary completion1 Jan 2027 (estimated)
- Study completion1 Jan 2027 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Lung CancerStudies of the same condition, open and under way.
- More trials run by Cairo UniversityThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
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
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Model description
- This is a parallel-group randomized controlled trial comparing the effectiveness of two ultrasound-guided regional anesthesia techniques-Rhomboid Intercostal Block (RIB) and Erector Spinae Plane Block (ESPB)-in managing postoperative pain in lung cancer patients undergoing thoracotomy.
- Masking
- Double blind
- Who is masked
- Participant, Outcomes assessor
- Enrolment
- 60 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Cairo University
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Sayed Mahmoud Abed, Cairo University
- Investigators
- Sayed M Abed, MD, Principal investigator, Associate Professor of Anesthesia and Pain Management, National Cancer Institute -- Cairo University
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07040618
- Sponsor's protocol ID
- NCI-CAIRO-RIb-ESPB-2025
- Acronym
- RIB-ESPB
- Status last verified
- Aug 2026
- First submitted
- 18 Jun 2025
- Last updated
- 1 Sep 2026
- Results posted
- No
- Data monitoring committee
- Yes
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No: Individual participant data (IPD) will not be shared due to institutional policy and privacy concerns. The study involves sensitive patient data from a cancer population, and data sharing may pose risks to confidentiality despite de-identification efforts. Access will remain restricted to the research team at the National Cancer Institute, Cairo University, in accordance with ethical approval and informed consent protocols.
Study at a glance
From the registry record, last updated by the sponsor on 1 Sep 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Assessing the Effectiveness of Rhomboid Intercostal and Erector Spinae Plane Blocks After Lung Cancer Thoracotomy
- ClinicalTrials.gov ID
- NCT07040618
- Acronym / sponsor ID
- RIB-ESPB / NCI-CAIRO-RIb-ESPB-2025
- Conditions
- Lung Cancer
- Study type
- Interventional
- Recruitment status
- Recruiting
- Enrolment
- 60 participants (estimated)
- Lead sponsor
- Cairo UniversityUniversity, hospital or other
- Study start
- 1 Jul 2025 (actual)
- Primary completion
- 1 Jan 2027 (estimated)
- Study completion
- 1 Jan 2027 (estimated)
- First posted
- 27 Jun 2025 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
This randomized trial compares rhomboid intercostal block (RIB) and erector spinae plane block (ESPB) for postoperative pain control in lung cancer patients undergoing thoracotomy. Sixty patients will be assessed for 24-hour morphine consumption, pain scores, hemodynamics, recovery time, satisfaction, and side effects. The study aims to identify the more effective technique for enhancing recovery and minimizing opioid use.
Detailed description
This randomized clinical trial aims to evaluate the analgesic efficacy of two ultrasound-guided regional anesthesia techniques-Rhomboid Intercostal Block (RIB) and Erector Spinae Plane Block (ESPB)-in female lung cancer patients undergoing thoracotomy at the National Cancer Institute, Cairo University. Thoracotomy is known for causing severe postoperative pain, which, if not effectively managed, can lead to chronic pain and impaired pulmonary function. Traditional techniques like thoracic epidural or paravertebral blocks, while effective, have limitations due to technical complexity and potential complications. Recently, interfascial plane blocks such as ESPB have shown promise for thoracic analgesia, and RIB has emerged as a technique potentially offering superior lateral thoracic wall coverage.
Sixty patients will be randomly assigned to receive either RIB or ESPB 30-45 minutes before surgery. The primary outcome is 24-hour postoperative morphine consumption. Secondary outcomes include visual analog scale (VAS) pain scores, hemodynamic stability, time to first analgesic request, recovery duration, patient satisfaction, and incidence of nausea and vomiting.
General anesthesia will be standardized across both groups. Data will be analyzed using appropriate statistical tests, and ethical approval will be obtained prior to patient enrollment. This study supports multimodal analgesia and aims to inform clinical practice in pain management after oncologic thoracic surgery.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Double blind (participant, outcomes assessor)
- Number of arms
- 2
- Model description
- This is a parallel-group randomized controlled trial comparing the effectiveness of two ultrasound-guided regional anesthesia techniques-Rhomboid Intercostal Block (RIB) and Erector Spinae Plane Block (ESPB)-in managing postoperative pain in lung cancer patients undergoing thoracotomy.
| Arm | Type | Receives |
|---|---|---|
| Ultrasound-guided Rhomboid Intercostal Block | Experimental | Procedure: Ultrasound-guided Rhomboid Intercostal BlockPatients in this group will receive a rhomboid intercostal block with 20-25 mL of 0.25% bupivacaine injected between the rhomboid major and intercostal muscles under ultrasound guidance 30-45 minutes before surgery. |
| Ultrasound-guided Erector Spinae Plane Block | Active comparator | Procedure: Ultrasound-guided Erector Spinae Plane BlockPatients in this group will receive an erector spinae plane block with 20-25 mL of 0.25% bupivacaine injected deep to the erector spinae muscle at the T4-T5 level under ultrasound guidance 30-45 minutes before surgery. |
Who may qualify
- Ages
- 18 to 65 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (5 listed)
- patients undergoing thoracotomy for lung cancer
- Age ≥ 18 years and ≤ 65 years
- ASA physical status II or III
- Body Mass Index (BMI) > 20 kg/m² and < 35 kg/m²
- Willing and able to provide informed consent
Key exclusion criteria (9 listed)
- Patient refusal
- ASA physical status IV
- Age < 18 years or > 65 years
- BMI < 20 kg/m² or > 35 kg/m²
- Known allergy or contraindication to local anesthetics or opioids used in the study
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Ultrasound-guided Rhomboid Intercostal BlockThis intervention involves an ultrasound-guided injection of 20-25 mL of 0.25% bupivacaine into the fascial plane between the rhomboid major and intercostal muscles. The patient is positioned laterally, and the block is performed at the T5-T6 level using a high-frequency linear ultrasound probe. The goal is to anesthetize the lateral cutaneous branches of the intercostal nerves to provide postoperative thoracic analgesia. | Procedure or surgery | Ultrasound-guided Rhomboid Intercostal Block |
| Ultrasound-guided Erector Spinae Plane BlockThis intervention consists of an ultrasound-guided injection of 20-25 mL of 0.25% bupivacaine into the plane deep to the erector spinae muscle at the T4-T5 transverse process level. The patient is positioned sitting or in lateral decubitus, and the procedure uses a curved or linear ultrasound probe. This block targets the dorsal and ventral rami of thoracic spinal nerves to manage postoperative pain after thoracotomy. | Procedure or surgery | Ultrasound-guided Erector Spinae Plane Block |
Primary outcome
24-hour postoperative morphine consumption
Time frame: Within the first 24 hours postoperatively
This outcome measures the total amount of morphine (in milligrams) administered to each patient within the first 24 hours after thoracotomy. Morphine will be given as rescue analgesia when the patient reports a visual analog scale (VAS) pain score of 4 or more. The cumulative dose will be recorded and compared between the Rhomboid Intercostal Block (RIB) and Erector Spinae Plane Block (ESPB) groups to evaluate the relative effectiveness of each regional anesthesia technique in managing postoperative pain.
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 1 Sep 2026.
- The morbidity, time course and predictive factors for persistent post-thoracotomy painLink provided by the sponsor.
- In patients undergoing thoracic surgery is paravertebral block as effective as epidural analgesia for pain management?Link provided by the sponsor.
- Individual participant dataSharing planned: No. Individual participant data (IPD) will not be shared due to institutional policy and privacy concerns. The study involves sensitive patient data from a cancer population, and data sharing may pose risks to confidentiality despite de-identification efforts. Access will remain restricted to the research team at the National Cancer Institute, Cairo University, in accordance with ethical approval and informed consent protocols.
Related trials for Lung Cancer
RecruitingObservational study
Dual Energy CT - a Tool for Delineation of Tumor and Organs at Risk in Radiotherapy
Brain Metastases, Bone Metastases
Active, not recruitingPhase 3
A Study of Combination Amivantamab and Carboplatin-Pemetrexed Therapy, Compared With Carboplatin-Pemetrexed, in Participants With Advanced or Metastatic Non-Small Cell Lung Cancer Characterized by Epidermal Growth Factor Receptor (EGFR) Exon 20 Insertions
Carcinoma, Non-Small-Cell Lung
RecruitingObservational study
Genetic Analysis of Birt Hogg-Dube Syndrome and Characterization of Predisposition to Kidney Cancer
Kidney Neoplasms, Kidney Cancer
RecruitingPhase 1
Autologous B7-H3 Chimeric Antigen Receptor T Cells in Previously Treated Extensive-Stage Small Cell Lung Cancer With Recurrent or Refractory Disease
Recurrent Small Cell Lung Cancer, Extensive-Stage Small Cell Lung Cancer
Enrolling by invitationObservational study
Patient Reported Outcomes Following Percutaneous Lung Ablation
Lung Neoplasm
Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part.
Sayed M Abed, MD principal investigator
Associate Professor of Anesthesia and Pain Management, National Cancer Institute -- Cairo University
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Ultrasound-guided Rhomboid Intercostal Block and Ultrasound-guided Erector Spinae Plane Block in people with Lung Cancer, run by Cairo University at 1 site in Egypt.
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 5 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: looking for participants now, as of the sponsor's last update on 1 Sep 2026. 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 Egypt. 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?
This study is still under way. Results are not available in the source record yet.
How can a doctor refer a patient or contact the research team?
Contact Sayed M Abed, MD (+20 122 680 6532, sayed.abed@nci.cu.edu.eg), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
24-hour postoperative morphine consumption (time frame: Within the first 24 hours postoperatively). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
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 1 Sep 2026.