SPS Block vs. Surgical Intercostal Block for Chronic Pain After Thoracoscopic Surgery

Evaluation of Serratus Posterior Superior (SPS) Block Versus Surgical Intercostal Blockade in Preventing Chronic Post-Thoracotomy Pain After Video-Assisted Thoracoscopic Surgery (VATS): A Randomized, Prospective, Comparative Study.

This study aims to evaluate the efficacy of ultrasound-guided Serratus Posterior Superior (SPS) block compared to surgeon-administered intercostal blockade in preventing chronic pain at 3, 6, and 12 months following Video-Assisted Thoracoscopic Surgery (VATS).

Although VATS is a minimally invasive technique, chronic post-thoracotomy pain (CPTP) remains a significant complication due to intercostal nerve injury. This study investigates whether the preemptive analgesic effect of the SPS block, performed under ultrasound guidance before surgery, reduces the incidence and severity of chronic pain more effectively than standard surgical intercostal blocks. Secondary objectives include assessing acute pain scores (VAS/NRS) within the first 24 hours, total opioid consumption, and duration of hospital stay.

Inclusion Criteria:

• ASA physical status I-III.
• Scheduled for elective unilateral Video-Assisted Thoracoscopic Surgery (VATS).

Exclusion Criteria:

• History of allergy to local anesthetics.
• Pre-existing chronic pain syndrome or neuropathic pain.
• Psychiatric disorders affecting pain assessment.
• Coagulation disorders.
• Previous thoracic surgery on the same side.