A Phase 2/3 interventional study of Interscalene brachial plexus block and anterior Supraclavicular nerve block in Nerve Block/Methods, sponsored by Children's Cancer Hospital Egypt 57357. Recruiting at 1 site in Egypt. Open to participants aged 5 Years to 18 Years. Per ClinicalTrials.gov, last updated 2026-09-01.
Sponsored by Children's Cancer Hospital Egypt 57357 · Phase 2/3, Interventional, and Treatment
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The goal of this clinical trial is to determine which regional block provides superior analgesia in pediatric patients undergoing thoracic surgery. The main questions it aims to answer are:
Participants will:
This prospective randomized controlled trial aims to evaluate and compare the effectiveness and safety of two regional analgesic techniques-suprascapular nerve block (SSNB) and interscalene brachial plexus block (ISB)-for managing ipsilateral shoulder pain (ISP) following pediatric thoracotomy. ISP is a common and distressing postoperative complication, affecting 30-85% of thoracotomy patients, and is often poorly responsive to systemic opioids and thoracic epidural analgesia due to its referred pain origin via the phrenic and suprascapular nerves.
Identifying effective targeted analgesic strategies is therefore clinically important. The study will be conducted at Children's Cancer Hospital 57357 and will include 126 pediatric patients (5-18 years, ASA II-III) undergoing elective open thoracotomy.
Participants will be randomized into three groups:
The primary objective is to compare the analgesic efficacy of SSNB and ISB in reducing ISP after thoracotomy, while secondary outcomes include postoperative opioid requirements and complication rates. This study is significant because it addresses a persistent clinical challenge in pediatric thoracic surgery pain management. By identifying an effective opioid-sparing regional analgesic technique, the findings may improve postoperative comfort, reduce opioid-related side effects, enhance recovery, and inform evidence-based postoperative pain management protocols for pediatric thoracotomy patients.
Children's Cancer Hospital Egypt 57357 is the lead sponsor of 21 studies on the registry; 5 are open to participants now.
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Exclusion Criteria:
Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
The anaesthetists’ scale of health before surgery: I is healthy, II has a mild illness that is under control, III a severe one, IV a severe illness that is a constant threat to life. V and VI are used for the critically ill and for organ donors.
ASA physical status
The anaesthetists’ scale of health before surgery: I is healthy, II has a mild illness that is under control, III a severe one, IV a severe illness that is a constant threat to life. V and VI are used for the critically ill and for organ donors.
Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
Thoracic epidural analgesia + Interscalene brachial plexus block; will be done pre-emptive after induction of anesthesia with 0.25% bupivacaine with maximum dose of 2mg/kg.
Procedure: Interscalene brachial plexus block
Thoracic epidural analgesia + anterior supraclavicular nerve block will be done pre-emptive after induction of anesthesia with 0.25% bupivacaine with maximum dose of 2mg/kg.
Procedure: anterior Supraclavicular nerve block
Thoracic epidural analgesia only. Control group
Other: Thoracic Epidural Analgesia (TEA) only
regional anesthesia technique performed at the level of the upper trunks of the brachial plexus to provide pain relief and anesthesia for surgeries involving the shoulder, clavicle, and upper arm. It is commonly used in orthopedic and thoracic procedures where shoulder pain is significant.
is a regional anesthesia technique targeting the trunks of the brachial plexus just above the clavicle, providing rapid and dense anesthesia for surgeries of the upper limb below the shoulder. It is often referred to as the "spinal of the arm" because of its effectiveness in numbing the arm quickly.
Control- standard treatment. A regional anesthesia technique in which a local anesthetic (sometimes combined with opioids) is injected into the epidural space of the thoracic spine to block nerve transmission and provide pain relief.
Visual Analogue Scale (VAS score)
VAS is a tool used to measure the intensity of pain or other subjective experiences. It is a 10-centimeter line, one end represents "no pain" (0), and the other end represents "worst imaginable pain" (10). The patient marks a point on the line that reflects their pain level. The score is then measured in centimeters or millimeters from the "no pain" end, giving a numerical value. Scores are collected at multiple intervals (2, 4, 6, 12, and 24 hours). This approach accounts for the repeated measurements and evaluates the interaction between the intervention groups and time. 0 = No pain 1-3 = Mild pain 4-6 = Moderate pain 7-9 = Severe pain 10 = Worst imaginable pain
Time frame: Multiple intervals (2, 4, 6, 12, and 24 hours)
Total postoperative opioid consumption
Total postoperative opioid consumption will be compared across the three groups using a One-way ANOVA or the Kruskal-Wallis test, depending on the distribution of the data. Post-hoc pairwise comparisons will be conducted using Tukey's HSD or Dunn's test with Bonferroni correction to identify specific group differences.
Time frame: 24 hours postoperative
Incidence of adverse effects
The incidence of adverse effects will be compared using the Chi-square test, which is a statistical method used to compare the incidence (frequency or proportion) of categorical outcomes across groups.
Time frame: 24 hours postoperative
Plan to share: No
No publications or documents are linked to this record.
Started Jul 2026 (actual). Primary completion is estimated for Apr 2028, 21 months after the start.
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Children's Cancer Hospital Egypt 57357