Intertransverse Process Block for Postoperative Analgesia After Thoracotomy and Lobectomy
Trial Parameters
Brief Summary
This prospective, randomized, triple-blind, placebo-controlled clinical trial will investigate the effectiveness of the intertransverse process block (ITPB) for postoperative analgesia in patients undergoing elective thoracotomy with unilateral lobectomy. The study will be conducted at a single tertiary center in accordance with the principles of the Declaration of Helsinki, and written informed consent will be obtained from all participants. Patients will be randomized in a 1:1 ratio to receive either ultrasound-guided ITPB with 0.5% bupivacaine or placebo (normal saline) prepared in identical syringes to ensure allocation concealment. The block will be performed by an experienced anesthesiologist immediately after surgery and before emergence from anesthesia. Both groups will receive standardized general anesthesia, multimodal perioperative analgesia, and postoperative intravenous morphine patient-controlled analgesia (PCA). The trial aims to evaluate the analgesic efficacy and opioid-sparing effect of ITPB while maintaining safety and adherence to routine clinical practice. Outcomes will include postoperative pain scores, opioid consumption, rescue analgesia requirement, and adverse events.
Eligibility Criteria
Inclusion Criteria: * Provision of written informed consent Age between 18 and 85 years ASA Physical Status classification I-III Elective thoracotomy with planned unilateral lobectomy Anticipated hospital stay of at least one night Expected requirement for parenteral opioid analgesia for at least 24 hours postoperatively Ability to operate an intravenous patient-controlled analgesia (PCA) device Exclusion Criteria: * Patients undergoing emergency surgery Presence of infection or open wound at the injection site Coagulopathy Hepatic or renal failure Patients undergoing reoperation Patients with missing or incomplete data Pregnancy or lactation Tracheal malformation or tracheostomy Chronic opioid use (≥30 days within the last 3 months, ≥15 mg/day morphine equivalent) Patients exceeding the maximum safe local anesthetic dose based on weight (2.5 mg/kg, max 150 mg) Patients who refuse data privacy consent will be excluded from the study