Thoracic SurgeryNCT07063602
Sensory Anesthesia Achieved Through Different Paravertebral Block Approaches for Post-Op Pain Management After VATS Lung Resection
An observational study of Thoracic Surgery and Video-assisted, run by Centre hospitalier de l'Université de Montréal (CHUM) at 1 site in Canada.
Trial summary
Video-assisted thoracoscopic lung resection (VATS) is a minimally invasive surgical approach frequently used in the treatment of lung cancers. The most commonly used analgesic technique for this surgery is the paravertebral block with a single peroperative injection of local anesthetic. Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Thoracic Surgery, Video-assisted, Paravertebral Block
- What is being tested?
- Evaluation of the hypoesthesia of the thorax
- How many people
- 90 participants
- Where
- 1 siteCanada
- Study dates
- 10 Sep 2025to 10 Sep 2027
- Phase
- Observational
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
Study population: Patients scheduled for elective anatomical pulmonary resection by VATS at two institutions
Who may be able to join
- Patients aged 18 years and older
- American Society of Anesthesiologists (ASA) score 1-3
Who cannot join
- Contraindication to the paravertebral block (coagulopathy, use of anticoagulants or antiplatelet agents other than aspirin that have not been stopped according to hospital guidelines, thoracoscopic visualization of the paravertebral space expected to be difficult or impossible, anterior spinal surgery with potential discontinuity of the paravertebral space)
- Epidural analgesia preferred (high risk of thoracotomy, marginal lung function)
- Surgical criteria: conversion to thoracotomy necessary and thoracic epidural or other form of regional analgesia implemented post-operatively
- Known allergy to local anesthetics
- Language barrier, psychiatric, physical or mental condition making pain assessment impossible despite prior education
- Pregnancy
- Patient refusal to participate
Trial locations and contacts
1 site in 1 country. Contact the study team or a site near you to ask about taking part.
Canada1 site, 1 recruiting
- Recruiting
Centre Hospitalier de l'Universite de Montreal
Montreal, Quebec, H2X 3E4
Alex Moore, MD, 514-890-8000 ext. 12132, alex.moore@umontreal.ca
Julie Desroches, PhD, 514-890-8000 ext. 24542, julie.desroches.chum@ssss.gouv.qc.ca
About this study
Official title: Sensory Anesthesia Achieved Through Different Paravertebral Block Approaches for Post-Operative Pain Management After Videothoracoscopic Lung Resection
Video-assisted thoracoscopic lung resection (VATS) is a minimally invasive surgical approach frequently used in the treatment of lung cancers. The most commonly used analgesic technique for this surgery is the paravertebral block with a single peroperative injection of local anesthetic. However, a recent study conducted at our institution revealed that this approach provided less relief than expected in some patients. In light of these results, it becomes crucial to distinguish between technical failures (absence of sensitive anesthesia) and the intrinsic limits of the chosen regional analgesia technique (pain originating from an unanesthetized area or pain despite the presence of sensitive anesthesia) in order to better relieve patients.
This study aims to objectively assess the areas of anesthesia obtained through three methods of paravertebral block to evaluate their respective performance and optimize post-VATS analgesic management.
Read the detailed description
Video-assisted thoracoscopic lung resection (VATS) is a minimally invasive surgical approach frequently used in the treatment of lung cancers. Compared to traditional thoracotomy, it is associated with reduced acute postoperative pain and a faster recovery. However, this pain often remains moderate to severe and can, if poorly controlled, promote the development of chronic pain. A multimodal analgesic strategy is essential to limit the use of opioids and their side effects. The most commonly used analgesic technique is the paravertebral block. As part of the optimized recovery protocols at our institution, a single peroperative injection of local anesthetic, guided by thoracoscopy, is currently favored. This technique, which is simple and safe, promotes rapid mobilization of the patient. However, a recent study conducted at our institution revealed that this approach provided less relief than expected in some patients. In light of these results, it becomes crucial to distinguish between technical failures (absence of sensitive anesthesia) and the intrinsic limits of the chosen regional analgesia technique (pain originating from an unanesthetized area or pain despite the presence of sensitive anesthesia) in order to better relieve patients.
This study aims to objectively assess the areas of anesthesia obtained through three methods of paravertebral block to evaluate their respective performance and optimize post-VATS analgesic management.
The primary objective of the study is to compare the success rate of creating sensitive anesthesia of the thoracic wall in the acute postoperative phase of video-assisted thoracoscopic lung resection according to various administration methods (transpleural approach by the surgeon vs percutaneous approach by the surgeon vs ultrasound guided approach by the anesthesiologist).
- Conditions
- Thoracic Surgery, Video-assisted, Paravertebral Block
- Being tested
- Evaluation of the hypoesthesia of the thorax
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Evaluation of the hypoesthesia of the thoraxOther
In the recovery room, a member of the research team will come to assess the presence of hypoesthesia (loss of sensation) of the thorax using ice and a Von Frey filament applied at three different sections: midscapular, midaxillary and midclavicular.
| Study group | Role | What they receive |
|---|---|---|
| Paravertebral block using percutaneous, transpleural or ultrasound guidance technique | The investigators aim to conduct a prospective observational study including patients having a paravertebral block undergoing a VATS lung surgery. The paravertebral block administration technique will vary sequentially, meaning that the first 30 patients included will receive the percutaneous technique, and the next 30 will receive the transpleural technique by the surgeon. The other 30 patients will receive the paravertebral block under ultrasound guidance by the anesthesiologist.
Paravertebral block will be administered at two levels, T4 and T7, using the percutaneous, the transpleural or ultrasound guided technique. It will be administered by the surgeon (percutaneous and transpleural) or by the anesthesiologist (ultrasound guided) directly after the installation of the thoracoscope and before the start of lung and lymph node resection. The local anesthetic will be bupivacaine 0.5% with 5 mcg/mL of adrenaline for a total volume of 0.4 mL/kg. Receives: Other: Evaluation of the hypoesthesia of the thorax |
What is being measured
The primary outcome is the main question the study is designed to answer.
Success rate of the sensory block
The success rate of the sensory block, defined as a hypoesthetic level to ice or the Von Frey filament of at least T3 to T8 in the recovery room, assessed at mid-scapular, mid-axillary, and mid-clavicular.
Measured: One hour after the surgery
Secondary outcomes (9)
Severity of acute postoperative pain
The severity of acute postoperative pain according to the visual analog scale for pain (VAS, 0 to 100 mm, where 0 means "no pain" and 100 means the "worst possible pain.") at rest and during coughing, at the thorax 1 hour after surgery.
Measured: One hour after the surgery
Postoperative morphine-equivalents consumption
The total amount of morphine equivalents received perioperatively, including pre-emergence and recovery room doses.
Measured: Perioperative
Total duration in the operating room
Total lenght of stay of the patient in the operating room
Measured: At the end of the surgery
Time to recovery room discharge
The time before reaching the discharge criteria for the patient to leave the recovery room
Measured: 24 hours
Quality of the local anesthetic diffusion
The anesthesiologist in the operating room or the surgeon will visually assess the quality of local anesthetic diffusion (approximate number of levels) following the paravertebral block, considering possible technical or anatomical constraints.
Measured: After the parabertebral block, during the surgery
Incidence of nausea related to opioid consumption
Evaluation of the incidence of nausea (yes or no) in the recovery room
Measured: 24 hours
Incidence of vomiting related to opioid consumption
Evaluation of the incidence of vomiting (yes or no) in the recovery room
Measured: 24 hours
Incidence of pruritus related to opioid consumption
Evaluation of the incidence of pruritus (yes or no) in the recovery room
Measured: 24 hours
Incidence of postoperative hypotension requiring medical intervention
Evaluation of the incidence of postoperative hypotension requiring medical intervention (yes or no) in the recovery room
Measured: 24 hours
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted14 Jul 2025
- Study start10 Sep 2025
- Primary completion10 Sep 2027 (estimated)
- Study completion10 Sep 2027 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Thoracic SurgeryStudies of the same condition, open and under way.
- 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
- Observational
- Observational model
- Other
- Time perspective
- Prospective
- Enrolment
- 90 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Centre hospitalier de l'Université de Montréal (CHUM)
- Sponsor type
- University, hospital or other
- Responsible party
- Sponsor
- Investigators
- Alex Moore, MD, Principal investigator, Centre hospitalier de l'Université de Montréal (CHUM)
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07063602
- Sponsor's protocol ID
- 2026-13022
- Status last verified
- Oct 2026
- First submitted
- 30 Jun 2025
- Last updated
- 22 Oct 2026
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No