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NCT Number: NCT07367581

Costotransverse Foramen Block Versus Thoracic Paravertebral Block in Thoracotomy for Lung Cancer

This study aims to compare the costotransverse foramen block (CTFB) with thoracic paravertebral block (TPVB) in patients undergoing thoracotomy for lung cancer.

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Key information

Conditions

Costotransverse Foramen Block Lung Cancer Lung Diseases Lung Neoplasms Neoplasms Neoplasms by Site Respiratory Tract Diseases Respiratory Tract Neoplasms Thoracic Neoplasms Thoracic Paravertebral Block Thoracotomy

Age range

18 year–65 year

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

About this study

Thoracotomy is known to be one of the most painful surgeries. Managing post-thoracotomy pain is a major clinical challenge, as about 75% of patients report moderate to severe pain afterward.

Various regional and central analgesia techniques, such as thoracic epidural analgesia (TEA), thoracic paravertebral block (TPVB), and erector spinae plane block (ESPB), are employed in a multimodal approach. Although TEA has traditionally been considered the gold standard for thoracotomy pain control, concerns about its side effects have prompted the exploration of alternatives.

The costotransverse foramen block (CTFB), a recently introduced technique, has been examined in both cadaveric and case studies.

Who can participate

Healthy volunteers accepted: No

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

Inclusion criteria

  • Age > 18 years and ≤ 65 years old.
  • American Society of Anesthesiologists (ASA) physical status II-III.
  • Body mass index 18-35 kg/m2.
  • Patients scheduled for thoracotomies for lung cancer.

Exclusion criteria

  • Patient refusal.
  • History of sensitivity to local anesthetics.
  • History of psychological disorders.
  • Contraindication to regional anesthesia, e.g., local sepsis, pre-existing peripheral neuropathies, and coagulopathy.
  • Severe respiratory, cardiac, hepatic, or renal disease.
  • Morbid obesity.
  • Uncooperative patients.
  • Patients on chronic pain therapy.

Treatment and study plan

Costotransverse foramen block

Other

Patients will receive an ipsilateral ultrasound-guided costotransverse foramen block with injection of 20 ml bupivacaine 0.25%.

Thoracic paravertebral plane block

Other

Patients will receive an ipsilateral ultrasound-guided thoracic paravertebral plane block with injection of 20 ml bupivacaine 0.25%.

Primary outcomes

  1. Total morphine consumption

    Time frame: 24 hours postoperatively

    If the visual analog scale (VAS) is ≥ 4, rescue analgesics will be administered in the form of a 4 mg bolus of morphine.

Secondary outcomes

  1. Duration of analgesia

    Time frame: 24 hours postoperatively

    Duration of analgesia will be recorded from the end of surgery till first dose of morphine administrated.

  2. Degree of pain

    Time frame: 48 hours postoperatively

    Each patient will be instructed about postoperative pain assessment with the visual analog scale (VAS). VAS (0 represents "no pain" while 10 represents "the worst pain imaginable"). VAS will be recorded in post-anesthesia care unit (PACU) and after 1, 6, 12, 24 & 48 hours postoperatively

  3. Intraoperative fentanyl consumption

    Time frame: Intraoperatively

    Intraoperative fentanyl consumption will be recorded.

  4. Mean arterial blood pressure

    Time frame: 4 hours postoperatively

    Mean arterial blood pressure will be recorded before induction of general anesthesia to be defined as the baseline reading. Another reading will be noted immediately before surgical incision and at 20-minute intervals intraoperatively, and then hourly for the next 4 hours postoperatively.

  5. Heart rate

    Time frame: 4 hours postoperatively

    Heart rate will be recorded before induction of general anesthesia to be defined as the baseline reading. Another reading will be noted immediately before surgical incision and at 20-minute intervals intraoperatively, and then hourly for the next 4 hours postoperatively.

  6. Incidence of block-related side effects

    Time frame: 4 hours postoperatively

    Incidence of block-related side effects such as unexpected epidural anesthesia, pneumothorax, total spinal anesthesia, or local anesthetic intoxication will be recorded.

  7. Incidence of side effects

    Time frame: 4 hours postoperatively

    Incidence of side effects such as postoperative nausea and vomiting, drowsiness, or dyspnea will be recorded.

Study contacts

Contact information is provided by the study sponsor or research team.

Mai M Elrawas, MD

CONTACT

[email protected]

00201222177242

Sponsors and collaborators

Lead sponsor

National Cancer Institute, Egypt

Other

Registry information

Official study title

Costotransverse Foramen Block Versus Thoracic Paravertebral Block in Thoracotomy for Lung Cancer: A Randomized Controlled Trial

Important dates

Study start
2026
Primary completion
2026
Study completion
2026
First posted
Jan 26, 2026
Registry last updated
Jan 27, 2026

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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