Rhomboid Intercostal Block vs Erector Spinae Block
Assessing the Effectiveness of Rhomboid Intercostal and Erector Spinae Plane Blocks After Lung Cancer Thoracotomy
Cairo University
60 participants
Jul 1, 2025
INTERVENTIONAL
Conditions
Summary
This randomized trial compares rhomboid intercostal block (RIB) and erector spinae plane block (ESPB) for postoperative pain control in lung cancer patients undergoing thoracotomy. Sixty patients will be assessed for 24-hour morphine consumption, pain scores, hemodynamics, recovery time, satisfaction, and side effects. The study aims to identify the more effective technique for enhancing recovery and minimizing opioid use.
Eligibility
Inclusion Criteria5
- patients undergoing thoracotomy for lung cancer
- Age ≥ 18 years and ≤ 65 years
- ASA physical status II or III
- Body Mass Index (BMI) \> 20 kg/m² and \< 35 kg/m²
- Willing and able to provide informed consent
Exclusion Criteria9
- Patient refusal
- ASA physical status IV
- Age \< 18 years or \> 65 years
- BMI \< 20 kg/m² or \> 35 kg/m²
- Known allergy or contraindication to local anesthetics or opioids used in the study
- History of chronic pain or psychological disorders
- Contraindications to regional anesthesia (e.g., local infection, coagulopathy, pre-existing peripheral neuropathy)
- Severe respiratory, cardiac, hepatic, or renal disease
- \-
Interventions
This intervention involves an ultrasound-guided injection of 20-25 mL of 0.25% bupivacaine into the fascial plane between the rhomboid major and intercostal muscles. The patient is positioned laterally, and the block is performed at the T5-T6 level using a high-frequency linear ultrasound probe. The goal is to anesthetize the lateral cutaneous branches of the intercostal nerves to provide postoperative thoracic analgesia.
This intervention consists of an ultrasound-guided injection of 20-25 mL of 0.25% bupivacaine into the plane deep to the erector spinae muscle at the T4-T5 transverse process level. The patient is positioned sitting or in lateral decubitus, and the procedure uses a curved or linear ultrasound probe. This block targets the dorsal and ventral rami of thoracic spinal nerves to manage postoperative pain after thoracotomy.
Locations(1)
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NCT07040618