Rhomboid Intercostal and Subserratus Plane Block vs Erector Spinae Plane Block in Video-Assisted Thoracoscopic Surgery

Comparison of the Efficacy of Rhomboid Intercostal and Subserratus Plane Block (RISS) Versus Erector Spinae Plane (ESP) Blocks in Video-Assisted Thoracoscopic Surgery (VATS) for Postoperative Pain Management and Respiratory Function

To compare the rhomboid intercostal subserratus plane block with the erector spinae plane block regarding their analgesic efficacy and effects on respiratory function for patients undergoing video-assisted thoracoscopic surgery.

Video-assisted thoracoscopic surgery (VATS) can be very painful and may lead to complications such as prolonged stays in intensive care, thromboembolic complications due to lack of early mobilization, chronic acute pain, and delirium if adequate analgesia is not provided. Therefore, using thoracic epidural, paravertebral, or regional blocks as part of multimodal analgesia is recommended to provide effective pain relief.

This study aims to compare the effects of the erector spinae plane block (ESP) and rhomboid intercostal subserratus plane block (RISS) on postoperative analgesia and the improvement of respiratory parameters in patients undergoing VATS.

The primary objective is to evaluate total analgesic consumption in the first 24 hours postoperatively. Secondary objectives include assessing active and dynamic pain scores, triflow performance, complications, and the length of hospital stays.

Inclusion Criteria:

• Patients who will undergo VATS
• Who agrees to participate
• American Society of Anesthesiologists (ASA) physical status I, II, and III
• Elective surgery
• Age between 18 and 80 years

Exclusion Criteria:

• Local anesthetic allergy
• Who disagrees to participate
• ASA physical status IV and V
• Emergency surgery
• Hemorrhagic disease
• Thoracic vertebrae deformity
• Thoracic vertebrae surgery