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NCT Number: NCT07002788

Comparison Paravertebral and Serratus Anterior Plane Block in Video-assisted Thoracoscopic Surgery.

Video-assisted thoracoscopic surgery (VATS) is a minimally invasive alternative to thoracotomy that emerged in the early 1990s, aiming to reduce surgical stress and postoperative pain. While VATS generally results in less pain than thoracotomy, patients may still experience significant discomfort. Effective pain control remains crucial in VATS to minimize postoperative complications, especially pulmonary and cardiac events, which can arise from inadequate ventilation and impaired sputum clearance due to pain.

Various strategies have been developed to manage postoperative pain, with multimodal approaches-combining regional or peripheral blocks with systemic analgesics such as NSAIDs and adjuvants-now considered standard. Among regional techniques, serratus anterior plane (SAP) block and thoracic paravertebral block (PVB) are commonly used. SAP block targets the thoracodorsal, long thoracic, and T2-T9 spinal nerves between the latissimus dorsi and serratus anterior muscles, providing effective anterolateral chest wall analgesia. PVB targets intercostal nerves within the paravertebral space and has shown superior pain control and improved lung function compared to systemic opioids or intrapleural local anesthetics.

At our center, both SAP and PVB are routinely used for postoperative analgesia in VATS procedures for patients with lung masses. Pain levels will be assessed using the Visual Analog Scale (VAS), a reliable tool for evaluating both acute and chronic pain, unaffected by age or gender.

This study aims to compare the effectiveness of SAP and PVB blocks in terms of postoperative pain, opioid requirements, and block-related complications in patients undergoing VATS under general anesthesia. The research is observational and will not alter routine clinical practices.

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This study is active but is not currently recruiting participants.

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Key information

Conditions

Lung Cancer (NSCLC) Adenocarcinoma Adenocarcinoma of Lung Bronchial Neoplasms Carcinoma Carcinoma, Bronchogenic Carcinoma, Non-Small-Cell Lung Lung Adenocarcinoma Lung Diseases Lung Neoplasms Neoplasms Neoplasms by Histologic Type Neoplasms by Site Neoplasms, Glandular and Epithelial Respiratory Tract Diseases Respiratory Tract Neoplasms Thoracic Neoplasms Video Assisted Thoracic Surgery (VATS)

Age range

18 year–90 year

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

Hacettepe Üniversitesi

Ankara, Turkey (Türkiye)

About this study

The study is a single-center randomized single-blind prospective clinical study, and after patients with appropriate criteria are included in the study; they will be assigned to either the paravertebral block arm or the serratus anterior plane block arm of the study using an internet-based randomization program (randomizer.org). Patients will not know which arm of the study they are in, but researchers who will evaluate the treatment outcome will know which block was applied to which patient. Paravertebral block or serratus anterior plane block will be applied to the patients under general anesthesia after VATS according to the arm they are in. After the patients are taken to the room, non-invasive arterial blood pressure, electrocardiogram, and peripheral oxygen saturation monitoring will be performed before general anesthesia. This is the routine monitoring method applied before anesthesia application. Standard routine general anesthesia will be applied to the patients. No change will be made in the general anesthesia approach due to the study.

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Patients between the ages of 18-64 who gave consent to participate in the study
  • Patients between the ages of 65-90 who received a score of 24 or more from the mini mental test and gave consent to participate in the study
  • ASA 1-3 patients

Exclusion criteria

  • Those with neuropathy,
  • Those with renal failure,
  • Those with liver failure,
  • Those with coagulopathy,
  • Those with local anesthetic allergy,
  • Those with infection in the area where the procedure will be performed,
  • Those with congenital muscle absence in the area where the block will be performed
  • Patients who did not give consent to participate in the study

Treatment and study plan

Bupivacaine

Drug

Used for regional anesthesia during VATS procedure (e.g., paravertebral or serratus anterior plane block)

Other names: Bupivakain

Morphine

Drug

Used for postoperative pain control via PCA device.

Other names: morfin

Paracetamol

Drug

Used as part of postoperative multimodal analgesia

Other names: Acetaminophen

Diklofenak Sodyum

Drug

Administered for postoperative pain management

Other names: NSAID

Primary outcomes

  1. Postoperative Pain Scores (VAS)

    Time frame: Within the first 24 hours after surgery

    Pain assessment will be performed by Res. Asst. Dr. Rabia Çakmak at the 1st, 3rd, 6th, 12th, and 24th hours postoperatively. Pain scores will be evaluated at rest and during coughing using the Visual Analog Scale (VAS), where 0 = no pain and 10 = worst imaginable pain.

  2. Total Postoperative Morphine Consumption

    Time frame: Within the first 24 hours after surgery

    Total morphine consumption in the first 24 hours after surgery will be recorded by the patient-controlled analgesia (PCA) device.

Secondary outcomes

  1. Total Rescue Analgesic Use

    Time frame: Within the first 24 hours after surgery

    Amount of additional analgesic medication (excluding PCA-administered morphine) required in the first 24 hours postoperatively will be recorded.

Sponsors and collaborators

Lead sponsor

Hacettepe University

Other

Registry information

Official study title

Comparison of Postoperative Analgesic Efficacy of Paravertebral Block and Serratus Anterior Plane Block in Patients Undergoing Video-assisted Thoracoscopic Surgery (VATS)

Important dates

Study start
2024
Primary completion
2025
Study completion
2026
First posted
Jun 4, 2025
Registry last updated
Jun 4, 2025

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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