Transverse Thoracic Plane Block, Midpoint Transverse Process Plane to Pleura Block and Erector Spinae Plane Block for Analgesia in Patients Undergoing Thoracoscopic Sympathectomy

Not Applicable

Not yet recruiting

• Conditions: Transverse Thoracic Plane Block; Midpoint Transverse Process Plane to Pleura Block; Erector Spinae Plane Block; Analgesia; Thoracoscopic Sympathectomy

• Registration Number: NCT06987110
• Lead Sponsor: Tanta University

Brief Summary

This study compares the transversus thoracic muscle plane block (TTPB), midtransverse to pleura block (MTPB), and erector spinae plane block (ESPB) for postoperative analgesia in patients undergoing thoracoscopic sympathectomy.

Detailed Description

Thoracoscopic sympathectomy is a well-established procedure for the treatment of various hyperhidrosis disorders and certain vascular conditions, involving the division of sympathetic nerve fibers in the thoracic cavity.

The erector spinae plane block (ESPB) is an interfascial regional anesthesia block for thoracic analgesia which can be performed by superficial or deep needle approach.

The mid-transverse to pleura block (MTPB) was first described as a modified paravertebral block.

Transversus thoracic muscle plane block (TTPB) is a newly developed technique in which LA is injected into the fascial plane between the transversus thoracic muscle and the internal intercostal muscles for blocking the anterior cutaneous branches of intercostal nerves from thoracic (Th) 2 to Th 6.

Study Timeline

• Status Verified: 2025-05
• Study First Submitted: 2025-05-15
• Study First Submitted QC: 2025-05-15
• Last Update Submitted: 2025-05-15
• Study First Posted: 2025-05-23
• Last Update Posted: 2025-05-23
• Study Start: 2025-05-25
• Primary Completion: 2025-10-01
• Study Completion: 2025-10-01

Recruitment & Eligibility

• Status: NOT_YET_RECRUITING
• Sex: All
• Target Recruitment: 60

Inclusion Criteria

• Age from 18 to 65 years.
• Both sexes.
• American Society of Anesthesiology (ASA) physical status I-II.
• Scheduled for thoracoscopic sympathectomy

Exclusion Criteria

• Coagulopathy.
• History of opiate abuse.
• Pre-existing chronic pain.
• Allergy to local anesthetics or analgesics.
• Infection at the site of injection.
• Mental or neurological disorders.
• Pregnancy

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Primary Outcome Measures

Name	Time	Method
Time to the 1st rescue analgesia	24 hours postoperatively	Time to the first request for the rescue analgesia (time from end of surgery to first dose of morphine administrated)

Secondary Outcome Measures

Name	Time	Method
Degree of patient satisfaction	24 hours postoperatively	Degree of patient satisfaction will be assessed on a 5-point Likert scale patient satisfaction (1, extremely dissatisfied; 2, unsatisfied; 3, neutral; 4, satisfied; 5, extremely satisfied)
Total morphine consumption	24 hours postoperatively	Rescue analgesia of morphine will be given as 3 mg bolus if the Visual Analogue Scale (VAS)\> 3 to be repeated after 30 min if pain persists until the VAS \< 4
Degree of pain	24 hours postoperatively	Each patient will be instructed about postoperative pain assessment with the Visual Analogue Scale (VAS). VAS (0 represents "no pain" while 10 represents "the worst pain imaginable"). VAS will be assessed at 0, 4, 8, 12, 18 and 24h postoperatively.
Heart rate	Till the end of surgery (Up to 2 hours)	Heart rate will be recorded preoperatively, before performing of block, and every 15 min till the end of surgery.
Mean arterial pressure	Till the end of surgery (Up to 2 hours)	Mean arterial pressure will be recorded preoperatively, before the block is performed, and every 15 minutes until the end of the surgery.
Incidence of complications	24 hours postoperatively	Incidence of complications such as pneumothorax, bradycardia, hypotension, nausea, vomiting, pruritis, respiratory depression, or any other complication will be recorded.

Trial Locations

Locations (1)

Tanta University; 🇪🇬 Tanta, El-Gharbia, Egypt