Not provided
Not provided
Not provided
Not provided
| ID | Type | Description | Link |
|---|---|---|---|
| 2024/276 | Other Identifier | Karadeiz Technical University, Local ethics Comitee |
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
This prospective observational study aims to compare the postoperative analgesic effectiveness of three commonly used pain management strategies in video-assisted thoracoscopic surgery (VATS): Serratus Posterior Superior Intercostal Plane Block (SPSIPB), Thoracic Epidural Analgesia (TEA), and systemic opioid analgesia. The study evaluates postoperative pain scores, opioid consumption, and the need for rescue analgesics within the first 24 hours after surgery. By analyzing analgesic performance and safety profiles of these techniques, the study seeks to provide evidence to guide optimal postoperative pain management for patients undergoing minimally invasive thoracic procedures.
This prospective observational clinical study investigates the comparative analgesic performance of three postoperative pain management strategies in patients undergoing video-assisted thoracoscopic surgery (VATS): Serratus Posterior Superior Intercostal Plane Block (SPSIPB), Thoracic Epidural Analgesia (TEA), and systemic opioid analgesia. SPSIPB is a recently defined interfascial plane block that may provide multi-dermatomal analgesia of the upper thoracic region with a less invasive profile compared with traditional neuraxial techniques. TEA, although considered effective for thoracic surgery, is associated with technical difficulty and potential adverse effects such as hypotension, urinary retention, and motor block. Systemic opioid analgesia remains widely used but may be limited by nausea, sedation, and opioid-related complications.
In this study, adult patients scheduled for elective VATS under general anesthesia will be managed with one of the three analgesic strategies as part of routine clinical practice. No randomization or allocation will be performed by the investigators; analgesic technique selection will follow standard clinical decision-making by the treating anesthesiologist. Postoperative pain will be evaluated using the Numerical Rating Scale (NRS) at predefined time points, including 0, 1, 2, 6, 12, and 24 hours after surgery. Total opioid consumption within the first 24 hours will be quantified as the primary outcome, expressed in tramadol-equivalent dosing. Secondary outcomes include the requirement for rescue analgesics, postoperative nausea and vomiting, hemodynamic parameters, and the Quality of Recovery-15 (QoR-15) score.
The study aims to provide comparative clinical evidence on the analgesic efficacy and tolerability of SPSIPB relative to TEA and systemic opioid analgesia in minimally invasive thoracic surgery. By identifying potential advantages or limitations of each technique, the findings may support optimization of multimodal analgesia protocols, improve postoperative comfort, and contribute to enhanced recovery strategies in VATS patients.
Not provided
Not provided
Not provided
Not provided
| Label | Type | Description | Intervention Names |
|---|---|---|---|
| SPSIPB Group | Patients receiving Serratus Posterior Superior Intercostal Plane Block (SPSIPB) as part of routine postoperative analgesia for VATS. | ||
| Thoracic Epidural Analgesia (TEA) Group | Patients receiving thoracic epidural analgesia with continuous epidural infusion for postoperative pain control following VATS. | ||
| Systemic Opioid Analgesia Group | Patients managed with intravenous systemic opioid analgesia (e.g., tramadol PCA) as standard postoperative analgesia after VATS. |
Not provided
| Measure | Description | Time Frame |
|---|---|---|
| Opioid Consumption | Total Opioid Consumption at 24 Hours | 24 hours postoperatively |
| Measure | Description | Time Frame |
|---|---|---|
| Pain Scores | Postoperative pain intensity will be assessed using the Numeric Rating Scale (NRS), which ranges from 0 to 10, where 0 = no pain and 10 = worst imaginable pain. Higher scores indicate worse pain. | 0, 1, 2, 6, 12, and 24 hours after surgery |
| Need for Rescue Analgesia |
Not provided
Inclusion Criteria:
Exclusion Criteria:
Not provided
Not provided
Adult patients (18-75 years) undergoing elective video-assisted thoracoscopic surgery (VATS) under general anesthesia at a tertiary university hospital. Patients will receive SPSIPB, thoracic epidural analgesia, or systemic opioid analgesia as part of routine clinical practice, and will be followed for postoperative pain outcomes within the first 24 hours.
| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Ali AKDOGAN, MD | Contact | +905322605414 | draliakdogan@yahoo.com |
Not provided
Not provided
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 37852626 | Background | Bilal B, Ciftci B, Alver S, Ahiskalioglu A, Tulgar S. Serratus posterior superior intercostal plane block: novel block for minimal invasive cardiac surgery -A report of three cases. Korean J Anesthesiol. 2024 Feb;77(1):166-168. doi: 10.4097/kja.23542. Epub 2023 Oct 18. No abstract available. | |
| 36883093 | Background |
Not provided
Not provided
Individual participant data will not be shared because the study does not include a data-sharing plan and contains identifiable clinical information that cannot be released.
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Number of patients requiring additional analgesics despite standard postoperative analgesia. |
| First 24 hours postoperatively |
| Incidence of Postoperative Nausea and Vomiting (PONV) | "PONV will be assessed using the Postoperative Nausea and Vomiting Intensity Scale (PONV Intensity Scale), which ranges from 0 to 3, where: 0 = No nausea or vomiting
Higher scores indicate more severe PONV. The presence of any nausea or vomiting and its severity will be recorded." | First 24 hours postoperatively |
| Heart Rate (beats per minute) | "Heart rate will be recorded intraoperatively and during the first 24 postoperative hours. Heart rate is measured in beats per minute (bpm). Higher values indicate increased sympathetic activity or hemodynamic stress." | Intraoperative and first 24 hours postoperative |
| Quality of Recovery Score (QoR-15) | "The quality of postoperative recovery will be evaluated using the Quality of Recovery-15 (QoR-15) questionnaire. The QoR-15 is a validated patient-reported outcome measure with a score range from 0 to 150. 0 = poorest possible recovery 150 = best possible recovery Higher scores indicate better postoperative recovery. Scores will be recorded preoperatively (baseline) and at 24 hours postoperatively." | Preoperative baseline and 24 hours postoperative |
| Time to First Opioid Request | Time elapsed between arrival in the postoperative care unit and the first analgesic request via PCA. | First 24 hours postoperatively |
| Mean Arterial Pressure (mmHg) | "Mean arterial pressure will be measured intraoperatively and during the first 24 postoperative hours. Mean arterial pressure is expressed in millimeters of mercury (mmHg). Higher or lower deviations from baseline may indicate hemodynamic instability." | Intraoperative and first 24 hours postoperative |
| Peripheral Oxygen Saturation (SpO₂,%) | "Peripheral oxygen saturation (SpO₂) will be monitored intraoperatively and during the first 24 postoperative hours. SpO₂ is reported as a percentage (%), ranging from 0% to 100%, where higher values indicate better oxygenation." | Intraoperative and first 24 hours postoperative |
| Tulgar S, Ciftci B, Ahiskalioglu A, Bilal B, Sakul BU, Korkmaz AO, Bozkurt NN, De Cassai A, Torres AJ, Elsharkawy H, Alici HA. Serratus Posterior Superior Intercostal Plane Block: A Technical Report on the Description of a Novel Periparavertebral Block for Thoracic Pain. Cureus. 2023 Feb 3;15(2):e34582. doi: 10.7759/cureus.34582. eCollection 2023 Feb. |
| 40275145 | Background | Koksal BG, Baytar C, Bayraktar E, Balbaloglu H. Effects of serratus posterior superior intercostal plane block on postoperative analgesia in patients undergoing breast cancer surgery: a randomized controlled trial. BMC Anesthesiol. 2025 Apr 24;25(1):209. doi: 10.1186/s12871-025-03092-0. |
| ID | Term |
|---|---|
| D000377 | Agnosia |
| ID | Term |
|---|---|
| D010468 | Perceptual Disorders |
| D019954 | Neurobehavioral Manifestations |
| D009461 | Neurologic Manifestations |
| D009422 | Nervous System Diseases |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |
Not provided
Not provided