| Registry | NCT07823920 |
|---|---|
| Status | Not yet recruiting |
| Phase | Not applicable |
| Study type | Interventional; randomized, parallel, masking: single, treatment |
| Enrollment | 80 (Estimated) |
| Sponsor | Assiut University (Other) |
| Conditions | Thoracostomy Pain Management, Pain Management, Chest Tube Insertion |
| Interventions | serratus anterior plane blocks, Erector Spinae Plane Block (Procedure) |
| Dates | start 2027-06-01 (estimated), primary completion 2029-12-30 (estimated), completion 2029-12-30 (estimated), first posted 2026-09-17, last updated 2026-09-17 |
| Locations | 1 site in Egypt |
Related Papers Related Patents Related Grants Related Experts
All trials for Thoracostomy Pain Management All trials for Pain Management All trials of serratus anterior plane blocks All trials of Erector Spinae Plane Block
In the emergency department, tube thoracostomy is a common critical procedure to manage symptomatic pleural issues such as pneumothorax and pleural effusion.\[1\] This technique employed to remove air or fluid from the pleural cavity, restore negative intrapleural pressure and let the lungs expand again to help normal cardiopulmonary function to be restored again. \[2\] However, the procedure is often associated with significant pain, with approximately 50% of patients reporting pain levels between 9-10 out of 10 during the intervention, and for pain management emergency physicians have traditionally combined local anesthetics with opioids or anxiolytics. Yet, these methods have notable drawbacks: opioids carry risks of addiction and adverse side effects (e.g., nausea/vomiting, respiratory depression, delirium), while procedural sedation is time-intensive, requires monitoring, and carries risks of complications such as apnea and hypotension.\[3\] Local anesthetic infiltration for pain management can also fail to effectively and evenly target the intercostal nerves responsible for chest wall sensation.\[4\] Ultrasound-guided fascial plane blocks (erector spinae plane and serratus plane blocks) have recently been proposed as targeted alternatives for reliable and extended pain control of tube thoracostomy as each block produces a unique distribution of anesthesia. \[5\] Despite establishing of these techniques for pain control during thoracic surgeries, its application in emergency settings for tube thoracostomy is underexplored enough yet \[6\], a gap explicitly identified in the recent literature.\[4\] Therefore, in this study we evaluate the impact of ESP and SAP block for pain management and overall quality of recovery which practically performed by emergency physicians.
| Arm | Type | Interventions | Description |
|---|---|---|---|
| SAPB | Experimental | Procedure: serratus anterior plane blocks | |
| ESPB | Experimental | Procedure: Erector Spinae Plane Block |
Sex: All, ages: 18 Years to 60 Years
Inclusion Criteria: * Adults aged ≥18 to =<60 years presenting to the ED requiring tube thoracostomy. * hemodynamically stable (systolic blood pressure ≥90 mmHg). * Able to provide informed consent. Exclusion Criteria: * Tension pneumothorax or hemodynamic instability requiring immediate tube insertion without time for block performance. * Known allergy or hypersensitivity to local anesthetics. * Infection or cellulitis overlying the intended needle insertion site. * Chronic opioid use/dependence, or substance use disorder that would confound pain and opioid-consumption outcomes. * Psychiatric illness, cognitive impairment, intoxication, or severe traumatic brain injury (GCS < 13) precluding reliable pain-score reporting or informed consent. * Body mass index ≥ 30 kg/m² (sonoanatomic landmarks less reliable). * Patients with spinal injury. * Patinets with fracture rib.
| Facility | City | Country | Status |
|---|---|---|---|
| Assiut University hospital | Asyut | Egypt |