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Post Operative AnalgesiaTPVB vs ESPNCT07782073

Comparison Between Paravertebral and Erector Spinal Block Efficacy in Robotic Thoracic Surgeries

A study testing Paravertebral Nerve Block and ESP block group in people with Post Operative Analgesia and Regional Anaesthesia, run by Soroka University Medical Center at 1 site in Israel.

Active, not recruiting

Under way, not looking for participants. Everyone needed has enrolled. The study is still running.

Official record
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Trial summary

The overall goal of this work is to find the preferred continues catheter- based thoracic block for patients who undergoing major ROBOTIC assisted thoracic surgery (Lobectomy, multiple segmental resection and thoracotomy). Specifically, this project aims to complete the following: 1. Read more about this study

Who is it for?
Ages 18 years and older
What is being tested?
Paravertebral Nerve Block and ESP block group
Could I receive a placebo?
No, everyone receives an active treatment
How many people
60 participants
Where
1 siteIsrael
Study dates
1 Jul 2026to 1 Jul 2028
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 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Age ≥18 years
  • All patients undergo major robotic thoracic surgery

Who cannot join

  • Patients who refuse to participate in the study.
  • Patients who are unable to give an informed consent.
  • Patients with local inflammation at the puncture site
  • Patients with known allergy to local anesthetisc
  • Pregnancy

Trial locations and contacts

1 site in 1 country.

Israel1 site
  • Soroka Medical center

    Beersheba

Other trials in Israel

About this study

Official title: A Prospective Comparison of Continues Catheter Paravertebral Block vs Continues Catheter Erector Spinal Block in Patients Undergoing Robotic Assistant Thoracic Surgery

The overall goal of this work is to find the preferred continues catheter- based thoracic block for patients who undergoing major ROBOTIC assisted thoracic surgery (Lobectomy, multiple segmental resection and thoracotomy). Specifically, this project aims to complete the following:

  1. To compare analgesic efficiency of continuous TPVB vs ESP block in patients undergoing major robotic thoracoscopic operation
  2. To assess failure rate, time to catheter placement and patient satisfaction of each block group
  3. To compare complication rate of each block
Read the detailed description

All adult patients undergoing major robotic thoracic procedures, such as Lobectomy, multiple segmental resection and thoracotomy. The recruitment period is planned for approximately 1 year. The follow-up period will be from admission until hospital discharge.

Video-assisted thoracic surgery (VATS) is a type of minimally invasive thoracic surgery that can remove parts of the diseased lung and lymph nodes. In video-assisted thoracoscopic surgery (VATS), a small tube called a thoracoscope is inserted through a small cut (incision) between the ribs. At the end of the tube is a small camera. This lets the surgeon see the entire chest cavity without having to open up the chest or spread the ribs. The surgeon then removes lung tissue with specially designed instruments inserted through one or two additional small incisions. The VATS technique can be used for other types of chest procedures involving the lungs, esophagus, thymus, pleural or pericardium besides lung cancer surgery.

Thoracic paravertebral block (TPVB) is the technique of injecting local anesthetic adjacent to the thoracic vertebra close to where the spinal nerves emerge from the intervertebral foramina. This results in ipsilateral somatic and sympathetic nerve blockade in multiple contiguous thoracic dermatomes above and below the site of injection

In recent years a new conceptual type of regional anesthesia has emerged: the Erector Spinae Plane Block (ESP block). Originally it was described in 2016 in a case report regarding analgesia intervention for thoracic neuropathic pain. Since then, there has been growing interest and research adding experience about the ESP block for pain control after thoracic and abdominal surgery and also traumatic injury of chest and abdomen. Current literature is limited to approximately 60 publications, the majority of which is case reports and case series.

Comparison of both techniques:

In thoracic surgery, both the Erector Spinae Plane (ESP) block and the Thoracic Paravertebral Block (TPVB) are utilized for analgesia.

Erector Spinae Plane (ESP) Block:

Advantages:

  • Technical Simplicity: The ESP block is generally easier to perform due to its superficial anatomical location, making it more accessible, especially for practitioners less experienced with deeper blocks.
  • Safety Profile: There's a reduced risk of complications such as pneumothorax because the injection site is farther from the pleura and major vascular structures.
  • Analgesic Efficacy: Studies suggest that ESP blocks provide effective analgesia for thoracic surgeries, with benefits comparable to TPVB when a similar number of injections are administered.

Disadvantages:

  • Potentially Limited Analgesic Coverage: While effective, the ESP block may not provide as extensive analgesic coverage as TPVB in some cases, potentially necessitating additional analgesic measures.
  • Limited Long-Term Data: As a relatively newer technique, long-term efficacy and safety data are less comprehensive compared to TPVB.

Thoracic Paravertebral Block (TPVB):

Advantages:

  • Established Efficacy: TPVB has a long-standing history of providing reliable analgesia for thoracic surgeries, with well-documented outcomes.
  • Comprehensive Analgesia: It offers effective unilateral analgesia, which can be advantageous for procedures involving one side of the thorax.

Disadvantages:

  • Technical Complexity: TPVB requires a higher degree of technical skill due to the proximity to the pleura and neurovascular structures, increasing the risk of complications.
  • Risk of Complications: There's a higher potential for adverse events such as pneumothorax, vascular puncture, and hypotension.

In summary, both ESP and TPVB are effective for analgesia in thoracic surgery. The choice between them should be guided by patient-specific factors, surgical requirements, and the clinician's expertise with each technique.

Being tested
Paravertebral Nerve Block, ESP block group
Keywords
Paravertebral block, Erector spinal block, continues block catheter based, Robotic surgery, Thoracoscopic surgery, Regional anesthesia

What participants receive

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

  • Paravertebral Nerve BlockProcedure or surgery

    Thoracic paravertebral block (TPVB) is the technique of injecting local anesthetic adjacent to the thoracic vertebra close to where the spinal nerves emerge from the intervertebral foramina. This results in ipsilateral somatic and sympathetic nerve blockade in multiple contiguous thoracic dermatomes above and below the site of injection It is effective in treating acute and chronic pain of unilateral origin from the chest and abdomen. Bilateral use of TPVB has also been described.

    Our understanding of the safety and efficacy of TPVB has improved significantly in the last two decades, prompting its use in children and neonates and for surgical anesthesia The TPVB is used to provide anesthesia and analgesia for breast surgery, surgery that requires coverage of the axilla (eg, creation of dialysis access, axillary lymph node dissection), or for thoraco-abdominal surgery as an alternative to thoracic epidural.

    The selected level for the block should be as close to the loca

  • ESP block groupProcedure or surgery

    we started performing ESP block for postoperative pain control in thoracic and abdominal surgery, with very satisfactory results so far. The block appears to be sufficient for postoperative pain control and the complications are yet to be seen. The results of our previous study show that ESP block is superior to pectoralis and serratus blocks-also used in thoracic surgery-in regard for a larger area of analgesia, easier injection, and longer duration. Also, it offers better safety profile than neuraxial analgesia or the thoracic paravertebral block

    The current literature suggests that ESP block is an excellent adjuvant to multi-modal analgesia not just for thoracic, but for abdominal surgery as well.

    It is an ultrasound guided interfacial block, achieved by injecting the local anesthetic solution between the transverse process and the erector spinae muscles (iliocostalis, longissimus, and spinalis). It can be performed either as a single shot or as a continuous catheter techniqu

Study groups in NCT07782073
Study groupRoleWhat they receive
group A - TPVBActive comparatorcontinues paravertebral block
Receives: Procedure: Paravertebral Nerve Block
group B - ESPActive comparatorcontinues erector spinal block
Receives: Procedure: ESP block group

What is being measured

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

  1. Post operative opioid consumption

    measured by MME (morphine equivalent)

    Measured: From completion of surgery through hospital discharge, assessed up to 24 hours postoperatively

  2. post operative pain

    measured by Visual Analog Scale (VAS); measured from 0 to 5, when 5- is maximal pain and 0 - no pain at all.

    Measured: Every 2 hours starting from PACU admission until hospital discharge, assessed up to 96 hours postoperatively.

Secondary outcomes (1)
  1. Patient satisfaction

    measured by score of 1 to 5, when 1 is the lowest (very not satisfied) and 5 is the highest (Very satisfied).

    Measured: immediately before discharge from the hospital

Timeline

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

  1. First posted24 Aug 2026
  2. Study start1 Jul 2026
  3. Primary completion1 Jul 2027 (estimated)
  4. Study completion1 Jul 2028 (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
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Model description
comparing two types of regional anesthesia blocks for specific type operation ( ROBOTIC )
Masking
Single blind
Who is masked
Investigator
Enrolment
60 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT07782073
Sponsor's protocol ID
0349-24
Acronym
TPVB vs ESP
Status last verified
Aug 2026
First submitted
28 Jul 2026
Last updated
24 Aug 2026
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Yes: all IPD that underlie results in a publication will be shared in future publication

Publications

  • 1. H,Nagano, T. Suda, Advantages and disadvantages of robotic and uniportal video-assisted thoracoscopic surgery, Video-assist Thorac Surg 2021;6:14 | http://dx.doi.org/ 2. Veronesi G. Robotic lobectomy and segmentectomy for lung cancer: results and operating technique. J Thorac Dis 2015;7 3. Novellis P, Bottoni E, Vonlaz E, et al. Robotic surgery, video-assisted thoracic surgery, and open surgery for early stage lung cancer: comparison of costs and outcomes at a single institute. J Thorac Dis 2018;1 4. Louie BE, Farivar AS, Aye RW, et al. Early experience with robotic lung resection results in similar operative outcomes and mobidity with compared with matched video-assisted thoracoscopic surgery cases. Ann Thorac Surg 2012;93:1598-6 5. Karmakar M., Thoracic Paravertebral Block, Anesthesiology 2001; 95:771-80 6. S. Feray,J. Lubach,G. P. Joshi,F. Bonnet, M. Van de Velde, PROSPECT guidelines for video-assisted thoracoscopic surgery: a systematic review and procedure-specific postoperative pain management recommendations, Anaesthesia 2022, 77, 311-325 7. Krishna, S.N.; Chauhan, S.; Bhoi, D.; Kaushal, B.; Hasija, S.; Sangdup, T.; Bisoi, A.K. Bilateral Erector Spinae Plane Block for Acute Post-Surgical Pain in Adult Cardiac Surgical Patients: A Randomized Controlled Trial. J. Cardiothorac. Vasc. Anesth. 2019, 33, 368-375. 8. Kawagoe, I.; Hayashida, M.; Satoh, D.; Kochiyama, T.; Fukuda, M.; Kishii, J. Postoperative analgesia in patients undergoing robot-assisted thoracic surgery: A comparison between thoracic epidural analgesia and intercostal nerve block combined with intravenous patient-controlled analgesia. Ann. Palliat. Med. 2021, 10, 1985-1993 9. A. Pawa,, T. Wojcikiewicz,, A. Barron, ,K. El-Boghdadly,, Paravertebral Blocks: Anatomical, Practical, and Future Concepts, Current Anesthesiology Reports (2019) 9:263-270 10. A. Ardon, J. Lee, C. D. Franco, K. T. Riutort, R. A. Greengrass, Paravertebral block: anatomy and relevant safety issues, Korean J Anesthe

Questions about this trial

What is this clinical trial studying?

A study testing Paravertebral Nerve Block and ESP block group in people with Post Operative Analgesia and Regional Anaesthesia, run by Soroka University Medical Center at 1 site in Israel.

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 2 inclusion and 5 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: under way, not looking for participants, as of the sponsor's last update on 24 Aug 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 Israel. 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?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Post operative opioid consumption (time frame: From completion of surgery through hospital discharge, assessed up to 24 hours postoperatively). The study lists 2 primary outcomes in all. 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 NCT07782073, which also lists 1 linked publication.

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 24 Aug 2026.

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