Comparison of ESP, SAP and SPSIP Blocks on VATS'

NCT07165873 | Completed

• 1 other identifier: 2023-05/04
• Study Type: interventional
• Target: 45
• Locations: 1 country
• Sites: 1

Brief Summary

This study aimed to compare erector spinae plane block (ESPB), serratus anterior plane block (SAPB), and serratus posterior superior intercostal plane block (SPSIPB) to determine the most suitable technique for maintaining postoperative analgesia in video-assisted thoracoscopic surgeries (VATS).

Conditions

Postoperative Pain Management

Keywords

erector spinae plane block; serratus anterior plane block; serratus posterior superior intercostal plane block; video-assisted thoracoscopic surgery; postoperative pain

Outcome Measures

Primary Outcomes (1)

• Visual analogue scale (VAS) score

  The Visual Analogue Scale (VAS) measures pain intensity. The VAS consists of a 10 cm line, with two end points representing 0 ('no pain') and 10 ('pain as bad as it could possibly be').

  postoperative 24 hours

Secondary Outcomes (1)

• Total tramadol consumption

  postoperative 24 hours

Study Arms (3)

ESP block

ACTIVE COMPARATOR

Erector spinae plane (ESP) block was performed in 15 patients. An ultrasound (USG) probe was placed in a sagittal orientation at the T5 level, 3 cm lateral to the midline, to visualize the transverse process. The trapezius, rhomboid major, and erector spinae muscles were identified. Using an in-plane technique, a needle was advanced cranio-caudally through these muscles until it reached the transverse process. After negative aspiration, 30 mL of 0.25% bupivacaine was injected deep to the erector spinae muscle. The block was performed unilaterally, targeting the surgical hemithorax.

Procedure: Erector Spinae Plane Block

SAP block

ACTIVE COMPARATOR

Serratus anterior plane (SAP) block was performed in 15 patients. The latissimus dorsi and serratus anterior muscles were identified by using USG at the midaxillary line at the 4th-5th rib level in a longitudinal parasagittal orientation. A needle was advanced from caudal to cranial using an in-plane approach, first targeting the plane between the latissimus dorsi and serratus anterior, and then deep to the serratus anterior. After negative aspiration, 10 mL was injected into the superficial plane and 20 mL into the deep plane, for a total of 30 mL of 0.25% bupivacaine. The block was performed unilaterally, targeting the surgical hemithorax.

Procedure: Serratus anterior plane block (SAP)

SPSIP block

ACTIVE COMPARATOR

The USG probe was placed 2-3 cm medial to the scapular spine to visualize the trapezius, rhomboid major, and serratus posterior superior muscles. At the level of the 2nd-3rd ribs, a needle was advanced into the plane between the serratus posterior superior muscle and the rib. After confirming negative aspiration, 30 mL of 0.25% bupivacaine was injected. The block was performed unilaterally, targeting the surgical hemithorax.

Procedure: Serratus posterior superior intercostal plane block

Interventions

Erector Spinae Plane Block PROCEDURE

30 mL of 0.25% bupivacaine was injected deep to the erector spinae muscle.

Also known as: ESP block

ESP block

Serratus anterior plane block (SAP) PROCEDURE

10 mL was injected into the superficial plane and 20 mL into the deep plane, for a total of 30 mL of 0.25% bupivacaine.

Also known as: SAP block

SAP block

Serratus posterior superior intercostal plane block PROCEDURE

30 mL of 0.25% bupivacaine was injected into the plane between the serratus posterior superior muscle and the rib.

Also known as: spsip block

SPSIP block

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Forty-five adult patients scheduled for elective wedge resection or biopsy under VATS, classified as American Society of Anesthesiologists (ASA) physical status I-III, were enrolled after providing written informed consent.

You may not qualify if:

• ASA class IV or higher,
• morbid obesity (BMI \> 40 kg/m²),
• body weight ≤ 50 kg,
• skin infection at the block site,
• refusal to participate,
• inability to cooperate during postoperative pain assessment,
• conversion to open surgery,
• preexisting pain,
• known allergy to any study medication,
• coagulopathy.

Sponsors & Collaborators

• Cumhuriyet University: lead

Study Sites (1)

Sivas Cumhuriyet University

Sivas, 58000, Turkey (Türkiye)

Location

MeSH Terms

Conditions

Pain, Postoperative

Condition Hierarchy (Ancestors)

Postoperative Complications; Pathologic Processes; Pathological Conditions, Signs and Symptoms; Pain; Neurologic Manifestations; Signs and Symptoms

Study Officials

• Oğuz Gündoğdu

  Sivas Cumhuriyet University School of Medicine, Anesthesiology and Reanimation

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: QUADRUPLE
• Who Masked: PARTICIPANT, CARE PROVIDER, INVESTIGATOR, OUTCOMES ASSESSOR
• Purpose: OTHER
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Associate Professor

Study Record Dates

• First Submitted: September 3, 2025
• First Posted: September 10, 2025
• Study Start: July 1, 2023
• Primary Completion: July 15, 2024
• Study Completion: August 15, 2024
• Last Updated: September 10, 2025

Record last verified: 2025-09

Data Sharing

• IPD Sharing: Will not share

Locations

TU (1)