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Peer-reviewedCC BYAnaesthesia Critical Care & Pain Medicine

Regional anaesthesia in Video or Robot assisted thoracic surgery: A French multicentre prospective observational cohort study (ARTIST study)

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Abstract

BACKGROUND: Minimally invasive thoracic surgery, including Video-Assisted Thoracic Surgery (VATS) and Robot-Assisted Thoracic Surgery (RATS), is associated with improved postoperative recovery compared to thoracotomy, particularly by reducing pain. The 2019 French guidelines recommend regional anaesthesia (RA) techniques for these procedures. The ARTIST study aimed to assess the prevalence of RA practices in thoracic surgery centres across France. METHODS: This study was a prospective, multicentre, observational study conducted across 23 French surgical centres. All consecutive patients aged ≥18 years scheduled for elective VATS/RATS were included. The primary objective was to determine the prevalence of RA use. Secondary objectives included describing anaesthesia management and assessing perioperative morbidity and mortality. Data were collected prospectively, and statistical analyses included univariate comparisons between RA techniques, with significance set at p < 0.05. RESULTS: From January 2021 to September 2022, 456 patients were enrolled. 413/456 (91%) received RA, including 56/413 (14%) thoracic epidural analgesia, 292/413 (71%) paravertebral blocks, 71/413 (17%) erector spinae plane blocks, 72/413 (17%) serratus anterior plane blocks, and 32/413 (8%) intercostal nerve blocks. No significant differences were observed between block types. In the RA group: 257/413(62%) patients received a single type of RA, while 102/413 (25%) patients received multiple RA techniques. CONCLUSIONS: RA is widely implemented in minimally invasive thoracic surgery, though significant variability exists in block selection and combination. Multiple-block strategies may provide benefits in postoperative recovery, but further studies are warranted to explore their optimal use and safety in VATS and RATS. REGISTRATION: ClinicalTrials.gov: NCT05126524.

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BibTeX
@article{gac2026regional,
  title = {{Regional anaesthesia in Video or Robot assisted thoracic surgery: A French multicentre prospective observational cohort study (ARTIST study)}},
  author = {G. Le Gac and Alexandre Mansour and B. Richard de Latour and Myriam Casez-Brasseur and R. Coves and J. Desbordes and O. Dransart‐rayé and G. Dufour and G. Gayraud and C. Gil and A Gouel-Chéron and P. Guerci and P. Huette and T Kerforne and C. Lebreton and A. Lemoine and O. Maupain and C. Parent and J. Piclet and F. Pihan and S. Prieur and E. Rineau and F. Roux and J. Selim and J. Thès and Hélène Beloeil and N. Nesseler},
  journal = {Anaesthesia Critical Care \& Pain Medicine},
  year = {2026},
  month = nov,
  doi = {10.1016/j.accpm.2026.101830},
  url = {https://hal.science/hal-05852534v1},
  note = {CC BY},
}
RIS
TY  - JOUR
TI  - Regional anaesthesia in Video or Robot assisted thoracic surgery: A French multicentre prospective observational cohort study (ARTIST study)
AU  - G. Le Gac
AU  - Alexandre Mansour
AU  - B. Richard de Latour
AU  - Myriam Casez-Brasseur
AU  - R. Coves
AU  - J. Desbordes
AU  - O. Dransart‐rayé
AU  - G. Dufour
AU  - G. Gayraud
AU  - C. Gil
AU  - A Gouel-Chéron
AU  - P. Guerci
AU  - P. Huette
AU  - T Kerforne
AU  - C. Lebreton
AU  - A. Lemoine
AU  - O. Maupain
AU  - C. Parent
AU  - J. Piclet
AU  - F. Pihan
AU  - S. Prieur
AU  - E. Rineau
AU  - F. Roux
AU  - J. Selim
AU  - J. Thès
AU  - Hélène Beloeil
AU  - N. Nesseler
PY  - 2026
DA  - 2026/11/04
JO  - Anaesthesia Critical Care & Pain Medicine
DO  - 10.1016/j.accpm.2026.101830
UR  - https://hal.science/hal-05852534v1
AB  - BACKGROUND: Minimally invasive thoracic surgery, including Video-Assisted Thoracic Surgery (VATS) and Robot-Assisted Thoracic Surgery (RATS), is associated with improved postoperative recovery compared to thoracotomy, particularly by reducing pain. The 2019 French guidelines recommend regional anaesthesia (RA) techniques for these procedures. The ARTIST study aimed to assess the prevalence of RA practices in thoracic surgery centres across France. METHODS: This study was a prospective, multicentre, observational study conducted across 23 French surgical centres. All consecutive patients aged ≥18 years scheduled for elective VATS/RATS were included. The primary objective was to determine the prevalence of RA use. Secondary objectives included describing anaesthesia management and assessing perioperative morbidity and mortality. Data were collected prospectively, and statistical analyses included univariate comparisons between RA techniques, with significance set at p < 0.05. RESULTS: From January 2021 to September 2022, 456 patients were enrolled. 413/456 (91%) received RA, including 56/413 (14%) thoracic epidural analgesia, 292/413 (71%) paravertebral blocks, 71/413 (17%) erector spinae plane blocks, 72/413 (17%) serratus anterior plane blocks, and 32/413 (8%) intercostal nerve blocks. No significant differences were observed between block types. In the RA group: 257/413(62%) patients received a single type of RA, while 102/413 (25%) patients received multiple RA techniques. CONCLUSIONS: RA is widely implemented in minimally invasive thoracic surgery, though significant variability exists in block selection and combination. Multiple-block strategies may provide benefits in postoperative recovery, but further studies are warranted to explore their optimal use and safety in VATS and RATS. REGISTRATION: ClinicalTrials.gov: NCT05126524.
SN  - 2352-5568
ER  -