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
- 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
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
Study at a glance
From the registry record, last updated by the sponsor on 22 Oct 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Sensory Anesthesia Achieved Through Different Paravertebral Block Approaches for Post-Operative Pain Management After Videothoracoscopic Lung Resection
- ClinicalTrials.gov ID
- NCT07063602
- Acronym / sponsor ID
- 2026-13022
- Conditions
- Thoracic Surgery, Video-assisted, Paravertebral Block
- Study type
- Observational
- Recruitment status
- Recruiting
- Enrolment
- 90 participants (estimated)
- Lead sponsor
- Centre hospitalier de l'Université de Montréal (CHUM)University, hospital or other
- Study start
- 10 Sep 2025 (actual)
- Primary completion
- 10 Sep 2027 (estimated)
- Study completion
- 10 Sep 2027 (estimated)
- First posted
- 14 Jul 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.
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.
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).
Study design
- Observational model
- Other
- Time perspective
- Prospective
- Number of arms
- 1
| Arm | Type | Receives |
|---|---|---|
| Paravertebral block using percutaneous, transpleural or ultrasound guidance technique | – | Other: Evaluation of the hypoesthesia of the thoraxThe 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. |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
- Study population
- Patients scheduled for elective anatomical pulmonary resection by VATS at two institutions
Key inclusion criteria (2 listed)
- Patients aged 18 years and older
- American Society of Anesthesiologists (ASA) score 1-3
Key exclusion criteria (7 listed)
- 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
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 |
|---|---|---|
| Evaluation of the hypoesthesia of the thoraxIn 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. | Other | Paravertebral block using percutaneous, transpleural or ultrasound guidance technique |
Primary outcome
Success rate of the sensory block
Time frame: One hour after the surgery
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.
9 secondary outcomes
Severity of acute postoperative pain
Time frame: One hour after the surgery
Postoperative morphine-equivalents consumption
Time frame: Perioperative
Total duration in the operating room
Time frame: At the end of the surgery
Time to recovery room discharge
Time frame: 24 hours
Quality of the local anesthetic diffusion
Time frame: After the parabertebral block, during the surgery
Incidence of nausea related to opioid consumption
Time frame: 24 hours
Incidence of vomiting related to opioid consumption
Time frame: 24 hours
Incidence of pruritus related to opioid consumption
Time frame: 24 hours
Incidence of postoperative hypotension requiring medical intervention
Time frame: 24 hours
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 22 Oct 2026.
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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.
Alex Moore, MD principal investigator
Centre hospitalier de l'Université de Montréal (CHUM)
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
An observational study of Thoracic Surgery and Video-assisted, run by Centre hospitalier de l'Université de Montréal (CHUM) at 1 site in Canada.
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 7 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 22 Oct 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 Canada. 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 Alex Moore, MD (514-890-8000 ext. 12132, alex.moore@umontreal.ca), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Success rate of the sensory block (time frame: One hour after the surgery). 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 22 Oct 2026; AzTrials last refreshed its copy on 31 Oct 2026.