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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.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Patients who received ESP block | Active Comparator | Those who received the erector spinae plane block for postoperative pain management |
|
| Patients who received RISS block | Active Comparator | Those who received the rhomboid intercostal subserratus plane block for postoperative pain management |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| ESP block group | Procedure | ESP blocks are performed for patients undergoing VATS. |
|
| Measure | Description | Time Frame |
|---|---|---|
| Opioid consumption | Total opioid consumption within the first 24 hours in the postoperative period. | Postoperative first 24 hours. |
| Measure | Description | Time Frame |
|---|---|---|
| Dynamic pain score | Postoperative pain scores during coughing and deep breathing are measured on a 10 cm scale, where "0" indicates no pain and "10" indicates the worst pain ever. | Postoperative first 24 hours. |
| Resting pain score |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Hande Gurbuz, Assoc Prof, MD, PhD | Contact | +905336515650 | handegrbz@gmail.com | |
| Yusuf Alan, MD | Contact | +90 539 621 09 77 | dryusufalan@gmail.com |
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| University of Health Sciences, Bursa City Hospital | Recruiting | Bursa | Nilufer | 16110 | Turkey (Türkiye) |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 28919152 | Background | Forero M, Rajarathinam M, Adhikary S, Chin KJ. Erector spinae plane (ESP) block in the management of post thoracotomy pain syndrome: A case series. Scand J Pain. 2017 Oct;17:325-329. doi: 10.1016/j.sjpain.2017.08.013. Epub 2017 Sep 12. | |
| 30169476 | Background | Elsharkawy H, Maniker R, Bolash R, Kalasbail P, Drake RL, Elkassabany N. Rhomboid Intercostal and Subserratus Plane Block: A Cadaveric and Clinical Evaluation. Reg Anesth Pain Med. 2018 Oct;43(7):745-751. doi: 10.1097/AAP.0000000000000824. |
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The data sets used in this research may be made available upon reasonable request to the corresponding author.
2026 to 2027
The data sets used in this research may be made available upon reasonable request to the corresponding author.
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| RISS block group | Procedure | RISS blocks are performed for patients undergoing VATS. |
|
Postoperative pain scores during rest are measured on a 10 cm scale, where "0" indicates no pain and "10" indicates the worst pain ever.
| Postoperative first 24 hours. |
| Pulmonary functions | Pulmonary functions are assessed using Triflow performance. Postoperative Triflow numbers (whether 1, 2, or 3 balls can be raised) for the patients are recorded. | Postoperative first 24 hours. |
| Complications | Complications regarding regional blocks and surgery (such as hematoma, pulmonary complications) are recorded. | Through study completion, an average of 1 year |
| Hospital stay time | The length of hospital stay is recorded. | Perioperatively |
| 28149550 | Background | Hsieh MJ, Wang KC, Liu HP, Gonzalez-Rivas D, Wu CY, Liu YH, Wu YC, Chao YK, Wu CF. Management of acute postoperative pain with continuous intercostal nerve block after single port video-assisted thoracoscopic anatomic resection. J Thorac Dis. 2016 Dec;8(12):3563-3571. doi: 10.21037/jtd.2016.12.30. |