Sensory Anesthesia Achieved Through Different Paravertebral Block Approaches for Post-Op Pain Management After VATS Lung Resection

NCT07063602 | Recruiting

• 1 other identifier: 2026-13022
• Study Type: observational
• Target: 90
• Locations: 1 country
• Sites: 1

Brief 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. 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.

Conditions

Thoracic Surgery; Video-assisted; Paravertebral Block

Outcome Measures

Primary Outcomes (1)

• 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.

  One hour after the surgery

Secondary Outcomes (9)

• Severity of acute postoperative pain

  One hour after the surgery

• Postoperative morphine-equivalents consumption

  Perioperative

• Total duration in the operating room

  At the end of the surgery

• Time to recovery room discharge

  24 hours

• Quality of the local anesthetic diffusion

  After the parabertebral block, during the surgery

Study Arms (1)

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.

Other: Evaluation of the hypoesthesia of the thorax

Interventions

Evaluation of the hypoesthesia of the thorax OTHER

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.

Paravertebral block using percutaneous, transpleural or ultrasound guidance technique

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

Patients scheduled for elective anatomical pulmonary resection by VATS at two institutions

You may qualify if:

• Patients aged 18 years and older
• American Society of Anesthesiologists (ASA) score 1-3

You may not qualify if:

• 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

Sponsors & Collaborators

• Centre hospitalier de l'Université de Montréal (CHUM): lead

Study Sites (1)

Centre Hospitalier de l'Universite de Montreal

Montreal, Quebec, H2X 3E4, Canada

RECRUITING

Study Officials

• Alex Moore, MD

  Centre hospitalier de l'Université de Montréal (CHUM)

  PRINCIPAL INVESTIGATOR

Central Study Contacts

Alex Moore, MD

CONTACT

514-890-8000; alex.moore@umontreal.ca

Julie Desroches, PhD

CONTACT

514-890-8000; julie.desroches.chum@ssss.gouv.qc.ca

Study Design

• Study Type: observational
• Observational Model: OTHER
• Time Perspective: PROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: June 30, 2025
• First Posted: July 14, 2025
• Study Start: September 10, 2025
• Primary Completion (Estimated): September 10, 2026
• Study Completion (Estimated): September 10, 2026
• Last Updated: February 27, 2026

Record last verified: 2026-02

Locations

CA (1)