Recruiting

Paravertebral Block

Sponsor:

Centre hospitalier de l'Université de Montréal (CHUM)

Code:

NCT07063602

Conditions

Thoracic Surgery

Video-assisted

Paravertebral Block

Eligibility Criteria

Sex: All

Age: 18+

Healthy Volunteers: Not accepted

Interventions

Evaluation of the hypoesthesia of the thorax

Study Details

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

Study ID

NCT07063602

Start date

Sep 10, 2025

Status verified date

Feb, 2026

Completion date

Sep 10, 2026

Anticipated

Primary completion date

Sep 10, 2026

Anticipated

Eligibility Criteria

Eligibility Criteria

Sex: All

Age: 18+

Healthy Volunteers: Not accepted

Inclusion Criteria:

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

Exclusion Criteria:

  • 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

Study Design

Enrollment

90 participants

Anticipated

Interventions and Outcome Measures

Arms

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.

Interventions

Evaluation of the hypoesthesia of the thorax

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.

Primary outcome measure

  • Success rate of the sensory block [ Time Frame: One hour after the surgery ]

Central Contacts and Locations

Central contacts

Alex Moore, MD

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

Julie Desroches, PhD

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

Locations

Centre Hospitalier de l'Universite de Montreal

Recruiting

Montreal, Quebec, Canada, H2X 3E4

Contacts

Alex Moore, MD

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

Julie Desroches, PhD

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

More Information

Sponsor

Centre hospitalier de l'Université de Montréal (CHUM)

Last update posted

Feb 27, 2026

Last verified

Feb, 2026

Trial information was received from ClinicalTrials.gov and was last updated on 2026-09-10. This information was provided to ClinicalTrials.gov by Centre hospitalier de l'Université de Montréal (CHUM) on 2026-02-27.