Evidence map›Paper›PMID 40849480›Full record

ArticleTrials2025

Randomized, controlled trial comparing the efficacy of intercostal nerve block in thoracoscopic surgery by timing: study protocol for a randomized clinical trial.

Yasuharu Sekine, Hideo Ichimura, Sho Ueda, Shinsuke Kitazawa, Naohiro Kobayashi, Yuya Murata, Kumiko Yamada, Shinichi Inomata, Kazushi Maruo, Yukio Sato

Abstract readClinical Trial Protocol
In one paragraph

Article in Trials, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Yasuharu SekineDepartment of Thoracic Surgery, University of Tsukuba Hospital, Tsukuba, Japan.
Hideo IchimuraDepartment of Thoracic Surgery, University of Tsukuba Hospital, Tsukuba, Japan. ichimura@md.tsukuba.ac.jp.ORCID http://orcid.org/0000-0002-2779-0108
Sho UedaDepartment of Thoracic Surgery, University of Tsukuba Hospital, Tsukuba, Japan.
Shinsuke KitazawaDepartment of Thoracic Surgery, University of Tsukuba Hospital, Tsukuba, Japan.
Naohiro KobayashiDepartment of Thoracic Surgery, University of Tsukuba Hospital, Tsukuba, Japan.
Yuya MurataDepartment of Anesthesiology, University of Tsukuba Hospital, Tsukuba, Japan.
Kumiko YamadaDepartment of Anesthesiology, University of Tsukuba Hospital, Tsukuba, Japan.
Shinichi InomataDepartment of Anesthesiology, University of Tsukuba Hospital, Tsukuba, Japan.
Kazushi MaruoDepartment of Biostatistics, Institute of Medicine, University of Tsukuba, Tsukuba, Japan.
Yukio SatoDepartment of Thoracic Surgery, University of Tsukuba Hospital, Tsukuba, Japan.

Funding

University of Tsukuba Hospital 127
6 · The paper itself

Abstract

backgroundEven minimally invasive thoracic surgeries carry a postoperative cost in pain. While regional anesthesia may alleviate this anticipated pain, especially intercostal nerve blocks (ICNB), the timing of block administration for optimal effect (at the beginning of surgery vs. before wound closure) remains controversial. Here, we plan (1) to test the hypothesis that performing ICNB at the beginning of surgery provides superior postoperative analgesic effects compared to before wound closure and (2) to observe perioperative outcomes to determine whether the timing affects acute and chronic postoperative pain, or intraoperative patient management.

methodsThis single-blinded, single-center, randomized, controlled trial will be conducted at the Department of Thoracic Surgery, University of Tsukuba Hospital from Sep 29, 2024, to June 30, 2026. Patients 16-79 years old within the regular population of patients undergoing lung wedge resection via video-assisted thoracoscopic surgery (VATS) without a utility window approach and who are ASA-PS classes 1-3 will be enrolled to receive ICNB either pre-operatively or before wound closure. Groups will be single-blinded (patient only) at random, and the primary outcome will be assessment by Numerical Rating Scale (NRS) pain scores during movement, measured 4 h after returning to the ward. Secondary outcomes will be (1) any additional analgesic use within the 4-h return window, (2) intraoperative measurements (including amounts of remifentanil used, time from surgery completion to extubation, occurrence of shivering or nausea after extubation, use of antiemetics, and maximum blood pressure/heart rate), (3) acute pain during hospitalization (using routinely administered NRS), (4) postoperative analgesic use, and (5) quality of life (QOL) scores on EQ-5D and SF-36 questionnaires at preoperative and 3-month postoperative timepoints. Chronic pain at 3 months post-surgery will also be determined by NRS. DISCUSSION: A complete evaluation of ICNB efficacy as a preemptive analgesic approach will contribute to the development of improved perioperative pain management techniques. A reduction in the duration of surgery-related symptoms and an improvement in postoperative QOL will be the result.

trial registrationJapan Registry of Clinical Trials: identifier jRCT1031240358. Registered on 29 Sep 2024.  https://jrct.niph.go.jp/latest-detail/jRCT1031240358 .

Indexed as

Intercostal NervesNerve BlockPostoperative PainThoracic Surgery, Video-AssistedAdolescentAdultAgedFemaleHumansMaleMiddle AgedPain MeasurementRandomized Controlled Trials as TopicSingle-Blind MethodTime FactorsTreatment OutcomeAcute postoperative painChronic postoperative painIntercostal nerve blockPatient-reported outcomePreemptive analgesic effectVideo-assisted thoracoscopic surgery

Identifiers

PMID40849480
PMCPMC12375271

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.