Ultrasound Guided Erectror Spinae Block Versus Intracavitary During Medical Thoracoscopy

NCT07572019 | Not Yet Recruiting Phase 2 DMC

• 1 other identifier: Medical pleuroscopy
• Study Type: interventional
• Target: 100
• Locations: 0 countries
• Sites: N/A

Brief Summary

The primary aim: is to compare the effect of US guided ESP block at two levels versus intracavitary blockade in medical thoracoscopy on total peri-procedural (intraoperative and post-operative 12 hours) nalbuphine consumption (mg) during medical thoracoscopy. Secondary aims: Time to first rescue analgesia, postoperative VAS, haemodynamics, recovery time (Aldert \> 9), and adverse events

Conditions

PLEURA DISEASE

Outcome Measures

Primary Outcomes (1)

• The primary aim: is to compare the effect of US guided ESP block at two levels versus intracavitary blockade in medical thoracoscopy on total peri procedural nalbuphine (mg) consumption during medical thoracoscopy

  intraoperative and post-operative 12 hours

Study Arms (2)

50 patients will receive two levels of ultrasound-guided erector spinae plane block (ESPB) at T5 an

ACTIVE COMPARATOR

Procedure: ultrasound-guided erector spinae plane block in medical pleuroscopy

patients will receive intracavitary anaesthesia ICA with total volume 40 ml, 20 ml of 0.25% bu

ACTIVE COMPARATOR

Procedure: Intracavitary anaesthesia ICA

Interventions

ultrasound-guided erector spinae plane block in medical pleuroscopy PROCEDURE

On the lateral decubitus position, under full aseptic technique; a high frequency (5-13 MHz) linear probe (or curvilinear in obese patients) of ultrasound covered sterilely will be placed in a parasagittal longitudinal orientation approximately 3 cm lateral to the spinous process to identify the trapezius, rhomboid major (if present), erector spinae muscle and thehyperechoic transverse process with its acoustic shadow, with the target being the fascial plane deep to the erector spinae muscle and superficial to the transverse process; the needle will be inserted in-plane in a cranial-to-caudal direction under real-time ultrasound guidance until it contacts the transverse process, after which 1-3 ml of normal saline is injected to confirm correct plane by lifting the erector spinae muscle off the transverse process, then following negative aspiration 20 ml of 0.25% bupivacaine at each level (10 ml 0.5% bupivacaine + 10 ml normal saline ) will be injected incrementally

50 patients will receive two levels of ultrasound-guided erector spinae plane block (ESPB) at T5 an

Intracavitary anaesthesia ICA PROCEDURE

After skin infiltration with lidocaine 2%, at the entry point of the trocar, small (2-4 cm) skin incision in the chest wall will be done, A trocar will be introduced into the pleural cavity. If necessary, air is introduced to allow the lung to collapse, creating space to view the pleural surface. The thoracoscope will be inserted to visualize the pleura. The interventional pulmonologist will receive the pre-prepared syringe from the block anaesthetist and will administer the solution intracavitarily via the thoracoscope working channel, without knowledge of its contents. In both groups, a total volume of 40 mL of solution is administered: 20 mL is sprayed over the costal, diaphragmatic, and mediastinal pleura via the thoracoscope working channel, and an additional 20 mL is injected through the chest tube inserted at the end of the procedure , 10-mL normal saline flush, and the chest tube is then clamped for 5 minutes

patients will receive intracavitary anaesthesia ICA with total volume 40 ml, 20 ml of 0.25% bu

Eligibility Criteria

• Age: 25 Years - 65 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• patients belonging to American Society of Anesthesiologists (ASA) I-III scheduled for medical thoracoscopy under adequate sedation and analgesia.

You may not qualify if:

• Patients will be excluded if; history of allergy or contraindication to any of the studied drugs, BMI more than 35 kg/m2, chronic opioid use or abuse, patients for whom ESPB block is contraindicated (patient refusal, coagulation disorder, skin infection at the injection site), history of post-thoracotomy, chest wall deformity, severe uncontrolled comorbidity, intubated patients, or if the interventional physician wants general anaesthesia from the start

Sponsors & Collaborators

• Kafrelsheikh University: lead

Central Study Contacts

Donia Hany Hany, MD

CONTACT

01014498540; doniahany1788@gmail.com

Study Design

• Study Type: interventional
• Phase: phase 2
• Allocation: RANDOMIZED
• Masking: TRIPLE
• Who Masked: PARTICIPANT, CARE PROVIDER, OUTCOMES ASSESSOR
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Lecturer of anesthesia and surgical ICU

Study Record Dates

• First Submitted: April 30, 2026
• First Posted: May 7, 2026
• Study Start (Estimated): May 15, 2026
• Primary Completion (Estimated): July 15, 2026
• Study Completion (Estimated): July 20, 2026
• Last Updated: May 7, 2026

Record last verified: 2026-04

Data Sharing

• IPD Sharing: Will not share