Video Assisted Thoracic Surgery (VATS)VATSNCT06996691
Erector Spinae Plane Block Versus Serratus Anterior Plane Block in VATS
A study testing Erector Spinae Plane Block (ESPB) group and Serratus Anterior Plane Block (SAPB) group in people with Video Assisted Thoracic Surgery (VATS), run by Ain Shams University at 1 site in Egypt.
Trial summary
Pain control remains challenging in patients undergoing video-assisted thoracoscopic surgery (VATS). It is advised to use a regional block to lower postoperative opioid usage. This study evaluates efficacy of Erector spinae plane (ESP) block in comparison to Serratus anterior plane block (SAP) in pain management for… Read more about this study
- Who is it for?
- Ages 18 to 70 years
- Conditions the study is for
- Video Assisted Thoracic Surgery (VATS)
- What is being tested?
- Erector Spinae Plane Block (ESPB) group and Serratus Anterior Plane Block (SAPB) group
- Type of treatment
- Surgery or procedure
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 40 participants
- Where
- 1 siteEgypt
- Study dates
- 1 May 2025to 15 Aug 2025
- 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 70 years
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- body mass index (BMI)=18 to 40 kg/m2
Who cannot join
- Contraindications to regional anesthesia as bleeding disorders , allergy to local anesthetic or infection at block site
- pre-existing chronic pain
- history of opiate abuse
- sepsis
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
faculty of medicine Ain Shams University
Cairo, 02
abdallah soudi, 01111228925, Dr.soudi2014@med.asu.edu.eg
About this study
Official title: A Comparative Study of Erector Spinae Plane Block Versus Serratus Anterior Plane Block for Postoperative Analgesia After Video-assisted Thoracoscopic Surgery
Pain control remains challenging in patients undergoing video-assisted thoracoscopic surgery (VATS). It is advised to use a regional block to lower postoperative opioid usage. This study evaluates efficacy of Erector spinae plane (ESP) block in comparison to Serratus anterior plane block (SAP) in pain management for patients undergoing video-assisted thoracoscopic surgery(VATS).
Read the detailed description
Minimally invasive thoracic surgery (MITS) has become more common over the past decade, with the proportion of lung resections performed using this technique increasing from 16% in 2005 to 47% in 2015.
VATS is a minimally invasive procedure that allows rapid recovery compared to thoracic surgery. Patients scheduled for VATS experience moderate to severe pain following the procedure. This represents a significant burden peri-operatively as there is a strong relationship between poor pain control and the development of complications like pneumonia and atelectasis due to interference with spontaneous deep breathing \& coughing. These complications have a negative impact on functional recovery; therefore, adequate postoperative pain relief assists in improving functional outcomes \& accelerates hospital discharge.
Multimodal techniques for pain control have been recommended by The American Society of Anesthesiologists (ASA) for the management of acute postoperative pain. Traditional analgesia based on opioids have multiple adverse effects such as respiratory depression, nausea, vomiting, itching and dizziness.
SAP block was first described in 2013 by Blanco as an analgesic technique.it is proposed to block the lateral cutaneous branch of the intercostal nerve, long thoracic nerve, and dorsal thoracic nerve. The block range of the SAPB covers the incisions of video-assisted thoracoscopic surgery (VATS) and the site of the chest tube, which are often located in the antero-lateral chest wall. The local anaesthetic injection was described in two planes: the 'superficial plane' and deep plane.
An ultrasound-guided ESP block was firstly reported in 2016. The ESP block injects a local anaesthetic around the erector spinae muscle at approximately the level of the T5. It may be able to block the dorsal and ventral rami of the thoracic spinal nerves. The first report of the successful use of this procedure was in 2016; the block was used to manage thoracic neuropathic pain in a patient with metastatic disease of the ribs and rib fractures
- Conditions
- Video Assisted Thoracic Surgery (VATS)
- Being tested
- Erector Spinae Plane Block (ESPB) group, Serratus Anterior Plane Block (SAPB) group
- Keywords
- VATS, Erector spinae plane block, Serratus anterior plane block
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Erector Spinae Plane Block (ESPB) groupProcedure or surgery
30ml of 0.25% levobupivacaine for erector spinae block at level of T5
Serratus Anterior Plane Block (SAPB) groupProcedure or surgery
30 mL of 0.25% levobupivacaine injected anteriorly to the rib and deep to the serratus anterior at level of 5 th rib
| Study group | Role | What they receive |
|---|---|---|
| Group A: Erector spinae block group | Active comparator | After selecting the target transverse process for the nerve block, place the transducer in a paramedian sagittal orientation, approximately 2cm away from the midline (spinous processes), and try to vizualize the transverse process at the level of T5 Complete the nerve block with 30ml of 0.25% levobupivacaine for erector spinae block Receives: Procedure: Erector Spinae Plane Block (ESPB) group |
| group B: Serratus anterior block group | Active comparator | High-frequency linear transducer should be placed on the patient's midaxillary line in the transverse plane, at the level of the fifth rib. With the rib, pleural line, and overlying serratus anterior and latissimus dorsi muscles visualized.
Then, using ultrasound guidance, the needle is advanced in-plane and the local anesthetic is injected anteriorly to the rib and deep to the serratus anterior.
After opening the fascial plane, a volume of dilute local anesthetic, 30 mL of 0.25% levobupivacaine, should be gradually injected. Receives: Procedure: Serratus Anterior Plane Block (SAPB) group |
What is being measured
The primary outcome is the main question the study is designed to answer.
post operative opioid consumption
post operative meperidine consumption throughout
Measured: 24 hours post operative
Secondary outcomes (2)
intraoperative fentanyl consumption
total introperative fentanyl dose
Measured: during the surgery
the numerical rating scale
a segmented numeric version of the visual analog scale (VAS) in which a respondent selects a whole number (0 to 10 integers) that best reflects the intensity of their pain. 0 representing one pain extreme (e.g., "no pain") and 10 representing the other pain extreme (e.g., "pain as bad as you can imagine" and "worst pain imaginable")
Measured: 24 hours post operative
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted30 May 2025
- Study start1 May 2025
- Primary completion31 Jul 2025 (estimated)
- Study completion15 Aug 2025 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Video Assisted Thoracic Surgery (VATS)Studies of the same condition, open and under way.
- More trials run by Ain Shams 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
- Masking
- Double blind
- Who is masked
- Participant, Outcomes assessor
- Enrolment
- 40 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Ain Shams University
- Sponsor type
- University, hospital or other
- Responsible party
- Sponsor
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT06996691
- Sponsor's protocol ID
- FMASU MS 145/2025
- Acronym
- VATS
- Status last verified
- Feb 2025
- First submitted
- 6 May 2025
- Last updated
- 30 May 2025
- Results posted
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- Yes
Study at a glance
From the registry record, last updated by the sponsor on 30 May 2025. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- A Comparative Study of Erector Spinae Plane Block Versus Serratus Anterior Plane Block for Postoperative Analgesia After Video-assisted Thoracoscopic Surgery
- ClinicalTrials.gov ID
- NCT06996691
- Acronym / sponsor ID
- VATS / FMASU MS 145/2025
- Conditions
- Video Assisted Thoracic Surgery (VATS)
- Keywords
- VATS, Erector spinae plane block, Serratus anterior plane block
- Study type
- Interventional
- Recruitment status
- Recruiting
- Enrolment
- 40 participants (estimated)
- Lead sponsor
- Ain Shams UniversityUniversity, hospital or other
- Study start
- 1 May 2025 (actual)
- Primary completion
- 31 Jul 2025 (estimated)
- Study completion
- 15 Aug 2025 (estimated)
- First posted
- 30 May 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.
Pain control remains challenging in patients undergoing video-assisted thoracoscopic surgery (VATS). It is advised to use a regional block to lower postoperative opioid usage. This study evaluates efficacy of Erector spinae plane (ESP) block in comparison to Serratus anterior plane block (SAP) in pain management for patients undergoing video-assisted thoracoscopic surgery(VATS).
Detailed description
Minimally invasive thoracic surgery (MITS) has become more common over the past decade, with the proportion of lung resections performed using this technique increasing from 16% in 2005 to 47% in 2015.
VATS is a minimally invasive procedure that allows rapid recovery compared to thoracic surgery. Patients scheduled for VATS experience moderate to severe pain following the procedure. This represents a significant burden peri-operatively as there is a strong relationship between poor pain control and the development of complications like pneumonia and atelectasis due to interference with spontaneous deep breathing \& coughing. These complications have a negative impact on functional recovery; therefore, adequate postoperative pain relief assists in improving functional outcomes \& accelerates hospital discharge.
Multimodal techniques for pain control have been recommended by The American Society of Anesthesiologists (ASA) for the management of acute postoperative pain. Traditional analgesia based on opioids have multiple adverse effects such as respiratory depression, nausea, vomiting, itching and dizziness.
SAP block was first described in 2013 by Blanco as an analgesic technique.it is proposed to block the lateral cutaneous branch of the intercostal nerve, long thoracic nerve, and dorsal thoracic nerve. The block range of the SAPB covers the incisions of video-assisted thoracoscopic surgery (VATS) and the site of the chest tube, which are often located in the antero-lateral chest wall. The local anaesthetic injection was described in two planes: the 'superficial plane' and deep plane.
An ultrasound-guided ESP block was firstly reported in 2016. The ESP block injects a local anaesthetic around the erector spinae muscle at approximately the level of the T5. It may be able to block the dorsal and ventral rami of the thoracic spinal nerves. The first report of the successful use of this procedure was in 2016; the block was used to manage thoracic neuropathic pain in a patient with metastatic disease of the ribs and rib fractures
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Double blind (participant, outcomes assessor)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Group A: Erector spinae block group | Active comparator | Procedure: Erector Spinae Plane Block (ESPB) groupAfter selecting the target transverse process for the nerve block, place the transducer in a paramedian sagittal orientation, approximately 2cm away from the midline (spinous processes), and try to vizualize the transverse process at the level of T5 Complete the nerve block with 30ml of 0.25% levobupivacaine for erector spinae block |
| group B: Serratus anterior block group | Active comparator | Procedure: Serratus Anterior Plane Block (SAPB) groupHigh-frequency linear transducer should be placed on the patient's midaxillary line in the transverse plane, at the level of the fifth rib. With the rib, pleural line, and overlying serratus anterior and latissimus dorsi muscles visualized. Then, using ultrasound guidance, the needle is advanced in-plane and the local anesthetic is injected anteriorly to the rib and deep to the serratus anterior. After opening the fascial plane, a volume of dilute local anesthetic, 30 mL of 0.25% levobupivacaine, should be gradually injected. |
Who may qualify
- Ages
- 18 to 70 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (1 listed)
- body mass index (BMI)=18 to 40 kg/m2
Key exclusion criteria (4 listed)
- Contraindications to regional anesthesia as bleeding disorders , allergy to local anesthetic or infection at block site
- pre-existing chronic pain
- history of opiate abuse
- sepsis
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 |
|---|---|---|
| Erector Spinae Plane Block (ESPB) group30ml of 0.25% levobupivacaine for erector spinae block at level of T5 | Procedure or surgery | Group A: Erector spinae block group |
| Serratus Anterior Plane Block (SAPB) group30 mL of 0.25% levobupivacaine injected anteriorly to the rib and deep to the serratus anterior at level of 5 th rib | Procedure or surgery | group B: Serratus anterior block group |
Primary outcome
post operative opioid consumption
Time frame: 24 hours post operative
post operative meperidine consumption throughout
2 secondary outcomes
intraoperative fentanyl consumption
Time frame: during the surgery
the numerical rating scale
Time frame: 24 hours post operative
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 30 May 2025.
- Individual participant dataSharing planned: Yes
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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.
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Erector Spinae Plane Block (ESPB) group and Serratus Anterior Plane Block (SAPB) group in people with Video Assisted Thoracic Surgery (VATS), run by Ain Shams 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 1 inclusion and 4 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 30 May 2025. 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 abdallah M soudi, M.D.56k (+201111228925, Dr.soudi2014@med.asu.edu.eg), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
post operative opioid consumption (time frame: 24 hours post operative). 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 30 May 2025; AzTrials last refreshed its copy on 7 Nov 2026.