Ultrasound-Guided Rhomboid-Intercostal Block Versus Thoracic Paravertebral Block for VATS Analgesia

NCT07465887 | Not Yet Recruiting DMC

• 1 other identifier: RIB-PVB-VATS-2026
• Study Type: interventional
• Target: 60
• Locations: 0 countries
• Sites: N/A

Brief Summary

Purpose of the study The goal of this research is to see which of two nerve-numbing techniques-the Rhomboid-Intercostal Block (RIB) or the Thoracic Paravertebral Block (PVB)-works better to control pain after chest surgery (specifically, video-assisted thoracoscopic surgery, or VATS). Both techniques use numbing medication to block pain signals after the operation. Who can participate? The researchers are looking for adults between 18 and 85 years old who are scheduled for a specific type of chest surgery (a 3-port VATS procedure). How will the research happen? Participants will be put into two equal groups by chance. One group will receive the RIB technique, and the other group will receive the PVB technique. Both procedures are done under ultrasound guidance after the completion of surgery, while the patient is still asleep. The pain levels of the participants will be measured at rest and when taking deep breaths at several times during the first 24 hours after surgery. Why is this study useful? This study aims to find out which pain relief method is more effective and if one results in fewer side effects, such as nausea or the need for stronger pain medications (opioids). These results will possibly help doctors provide better comfort to patients recovering from chest surgery in the future.

Conditions

Postoperative Pain; Thoracic Surgery; Thoracic Surgery, Video Assisted; Ultrasound Guided; Paravertebral Thoracic Block; Rhomboid Intercostal Block

Keywords

VATS; Rhomboid-intercostal Block; Paravertebral Thoracic Block; Regional Anesthesia; Postoperative Analgesia

Outcome Measures

Primary Outcomes (1)

• Postoperative Pain Intensity

  Pain intensity will be measured 1, 2, 6, 12, and 24 hours after extubation using the Numerical Rating Scale (NRS) ranging from 0 (no pain) to 10 (worst possible pain) . Measurements will be recorded at rest and during deep inspiration.

  Up to 24 hours after extubation

Secondary Outcomes (3)

• Total Opioid Consumption

  24 hours post-surgery

• Incidence of Complications

  24 hours post-surgery

• Time to First Request for Rescue Analgesia

  From extubation up to 24 hours post-surgery

Study Arms (2)

Ultrasound-Guided Rhomboid-Intercostal Block (RIB)

EXPERIMENTAL

Procedure: Ultrasound-Guided Rhomboid-Intercostal Block (RIB)

Ultrasound-Guided Thoracic Paravertebral Block (PVB)

ACTIVE COMPARATOR

Procedure: Ultrasound-Guided Thoracic Paravertebral Block (PVB)

Interventions

Ultrasound-Guided Rhomboid-Intercostal Block (RIB) PROCEDURE

This is an ultrasound-guided regional anesthesia procedure performed after the completion of the operation, while the patient is still asleep. A dose of 30 ml of 0.375% Ropivacaine is injected into the plane located between the rhomboid major and the intercostal muscles at the T5 level to provide postoperative analgesia

Ultrasound-Guided Rhomboid-Intercostal Block (RIB)

Ultrasound-Guided Thoracic Paravertebral Block (PVB) PROCEDURE

This is an ultrasound-guided regional anesthesia procedure performed after the completion of the operation, while the patient is still asleep. A dose of 30 ml of 0.375% Ropivacaine is injected into the thoracic paravertebral space at the T5 and T7 levels to provide postoperative analgesia

Ultrasound-Guided Thoracic Paravertebral Block (PVB)

Eligibility Criteria

• Age: 18 Years - 85 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Adults (18-85 years old),
• ASA physical status I-III
• scheduled for elective 3-port unilateral VATS.

You may not qualify if:

• Allergy to local anesthetics
• infection at the injection site
• coagulation disorders
• severe neurological disorder
• obesity (BMI \> 35)
• opioid addiction
• conversion to open thoracotomy, admission to ICU.

Sponsors & Collaborators

• Georgios Kotsovolis: lead

MeSH Terms

Conditions

Pain, Postoperative

Condition Hierarchy (Ancestors)

Postoperative Complications; Pathologic Processes; Pathological Conditions, Signs and Symptoms; Pain; Neurologic Manifestations; Signs and Symptoms

Central Study Contacts

Dimitra Katholiki Papazoglou

CONTACT

00306983150795; dimitapaz22@gmail.com

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: DOUBLE
• Who Masked: PARTICIPANT, OUTCOMES ASSESSOR
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR INVESTIGATOR
• PI Title: Kotsovolis Georgios, MD, Msc, PhD

Study Record Dates

• First Submitted: March 6, 2026
• First Posted: March 12, 2026
• Study Start: March 9, 2026
• Primary Completion (Estimated): March 1, 2027
• Study Completion (Estimated): March 1, 2027
• Last Updated: March 20, 2026

Record last verified: 2026-03

Data Sharing

• IPD Sharing: Will share
• Shared Documents: STUDY PROTOCOL, SAP, ICF