Effect of Patient Position on Erector Spinae Plane Block in Thoracic Surgery

Effect of Patient Position on Dermatomal Spread and Analgesic Outcomes of Erector Spinae Plane Block in Thoracic Surgery: A Prospective Randomized Clinical Trial

Status

Not yet recruiting

Phases

Unknown

Study type

Interventional

Source

ClinicalTrials.gov

Registry ID

NCT07387484

Enrollment

Registered

2026-02-04

Start date

2026-02-01

Completion date

2026-05-01

Last updated

2026-02-06

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Postoperative Pain, Thoracic Surgery, Video Assisted

Keywords

video assisted thorachoscopic surgery, erector spinae plane block

Brief summary

The erector spinae plane (ESP) block is a widely used regional anesthesia technique for postoperative analgesia in thoracic surgery. The block can be performed in different patient positions, most commonly sitting or lateral decubitus, but the effect of patient position on dermatomal sensory spread and analgesic efficacy has not been clearly established. This prospective, randomized, single-blind clinical trial aims to compare the effects of ESP block performed in sitting versus lateral decubitus position on dermatomal sensory distribution and postoperative analgesic outcomes in patients undergoing video-assisted thoracic surgery.

Detailed description

Adult patients scheduled for elective video-assisted thoracic surgery will be randomly assigned to receive ultrasound-guided unilateral erector spinae plane block either in the sitting position or in the lateral decubitus position. In both groups, the block will be performed at the same thoracic level using 30 mL of 0.25% bupivacaine under ultrasound guidance. Dermatomal sensory spread will be assessed 15 minutes after block placement using cold sensation (alcohol-soaked cotton) and pin-prick testing. Postoperative analgesia will be standardized in all patients using patient-controlled analgesia with tramadol. Pain scores and opioid consumption will be recorded during the first 24 postoperative hours. The primary outcome is the extent of dermatomal sensory spread. Secondary outcomes include postoperative pain scores, time to first rescue analgesic, and total opioid consumption within 24 hours.

Interventions

DRUGErector Spinae (ESP) Block with Bupivacaine (Marcaine®) sitting position

Erector spinae plane block-sitting position

DRUGErector Spinae (ESP) Block with Bupivacaine (Marcaine®) lateral position

Erector Spinae Plane Block-Lateral position

Study design

Allocation

RANDOMIZED

Intervention model

PARALLEL

Primary purpose

TREATMENT

Masking

DOUBLE (Subject, Outcomes Assessor)

Eligibility

Sex/Gender

ALL

Age

18 Years to 75 Years

Healthy volunteers

Inclusion criteria

* Age 18 to 75 years * ASA physical status II-IV * Scheduled for elective video-assisted thoracic surgery * Ability to provide written informed consent

Exclusion criteria

* Known allergy to local anesthetics * Chronic opioid use * Preexisting chronic pain * Severe cognitive impairment * Technical difficulty with positioning * Emergency surgery * Refusal to participate

Design outcomes

Primary

Measure	Time frame	Description
Dermatomal sensory spread	15 minutes after the block application	Cranial and caudal sensory limits and total number of dermatomes affected, assessed by cold sensation and pin-prick testing.

Secondary

Measure	Time frame	Description
Postoperative pain scores (Numeric Rating Scale)	Postoperative 0, 2, 6, 12, and 24 hours	Numeric Rating Scale, 0-10 points, 0=no pain, 10= worst pain imaginable
Total opioid consumption	First 24 postoperative hours	—

Outcome results

None listed

Source: ClinicalTrials.gov · Data processed: Feb 7, 2026