Thoracic paravertebral block (PVB) is commonly used for analgesia after thoracic procedures but is associated with known risks such as pneumothorax and hypotension. The intertransverse process block (ITPB) is a more recent regional technique proposed as an alternative that may provide comparable analgesia with a potentially different safety profile. Despite growing interest, few studies have directly compared these two techniques from the patient recovery perspective, and no trials have evaluated ultrasound-guided ITPB versus PVB specifically for postoperative recovery quality in elderly patients undergoing minimally invasive thoracic surgery.
This study is a two-centre, double-blind, parallel-group, randomized controlled trial. The trial will be conducted at West China Hospital and the Shangjin Branch of West China Hospital, Sichuan University, both located in Sichuan Province, China. A total of 152 participants will be enrolled and randomized in a 1:1 ratio to receive either ultrasound-guided ITPB or ultrasound-guided PVB.
Eligible participants are elderly patients aged 65 years or older who are scheduled to undergo video-assisted thoracoscopic surgery (VATS). Specific inclusion and exclusion criteria beyond age and planned surgery were not detailed in the source and therefore are not reported here. Written informed consent will be obtained from all participants prior to enrolment.
Participants will be randomized in a 1:1 allocation to one of the two block groups, yielding 76 participants per arm. The trial is described as double-blind; the source reports blinding but does not specify which trial personnel and outcome assessors will be blinded or the blinding procedures in detail.
Study participants will receive either ultrasound-guided intertransverse process block (ITPB) or ultrasound-guided paravertebral block (PVB) as the regional analgesic intervention. The source states that both procedures will be performed under ultrasound guidance. No additional procedural specifics, local anaesthetic types, volumes, or timing relative to surgery were reported in the source document.
The primary outcome measure is the Quality of Recovery-15 (QoR-15) score assessed on postoperative day 1. The QoR-15 instrument is a patient-reported outcome measure designed to quantify multidimensional recovery after surgery; however, detailed administration or threshold criteria were not provided in the source.
Secondary outcomes will capture recovery trajectories, analgesic efficacy, opioid use, safety and resource use. They include:
QoR-15 scores on postoperative days 2, 3, 7 and 30.
Pain intensity at rest and during movement measured with the Numerical Rating Scale (NRS) on postoperative days 1, 2 and 3.
Worst NRS resting pain score within 30 minutes of admission to the post-anaesthesia care unit (PACU).
Proportion of patients requiring rescue analgesia within 24 hours after surgery.
Patient satisfaction with analgesia within 24 hours after surgery.
Total opioid consumption within 24 hours after surgery.
Incidence of major complications of surgery within 7 days after surgery; the source does not list which specific complications are considered “major.”
Length of postoperative hospital stay.
Number of days at home within 30 days after surgery.
These secondary measures are intended to provide a comprehensive assessment of patient-centred recovery, analgesic effectiveness, opioid-sparing potential, and early postoperative safety.
The protocol acknowledges established risks with PVB, notably pneumothorax and hypotension, and aims to compare the two techniques in terms of recovery and complications. The source indicates that incidence of major surgical complications within 7 days is a predefined outcome. Details of adverse-event definitions, severity grading, or specific safety monitoring procedures were not reported in the source text.
The trial protocol received ethics approval from the Ethics Committee of West China Hospital, Sichuan University (approval no. 2603) and from the Ethics Committee of the Shangjin Branch of West China Hospital, Sichuan University (approval no. 2613). Written informed consent will be obtained from all participants prior to study procedures. The investigators plan to disseminate study results through publication in peer-reviewed journals.
The trial is registered in the Chinese Clinical Trial Registry with the number ChiCTR2600116524.
Note: The source document supplies the trial design, primary and secondary outcomes, site and ethics approval numbers, and registration. Specific procedural details (such as exact block techniques, local anaesthetic agents and doses, perioperative care protocols, and full inclusion/exclusion criteria) were not reported in the provided source text and therefore are not included here.