ESP vs SPSIP Block in VATS Analgesia

NCT07232940 | Recruiting

• 1 other identifier: Bursa City Hospital 001
• Study Type: interventional
• Target: 90
• Locations: 1 country
• Sites: 1

Brief Summary

Video-assisted thoracoscopic surgery (VATS) is a minimally invasive procedure performed through small thoracic incisions, but postoperative pain remains significant due to tissue and rib trauma. Poorly controlled pain may lead to chronic postoperative pain; therefore, optimal analgesia is essential. According to PROSPECT guidelines, erector spinae plane block (ESPB) or paravertebral block (PVB) are recommended for VATS. The recently defined serratus posterior superior intercostal plane block (SPSIPB) provides analgesia between C3-T10 levels, but its efficacy compared with ESPB has not been studied. This study aims to compare postoperative analgesic efficacy and patient satisfaction between ESPB and SPSIPB in VATS patients.

Conditions

Video-assisted Thoracoscopic Surgery (VATS); Serratus Posterior Superior Intercostal Plane Block

Keywords

Serratus posterior superior intercostal plane block; erector spinae plane block; pain management; Video-assisted thoracoscopic surgery (VATS)

Outcome Measures

Primary Outcomes (1)

• opioid consumption

  Tramadol will be prepared as 5mg/ml and patient-controlled analgesia will be administered without basal infusion, with a locking time of 20 minutes and a bolus dose of 10mg.

  0, 2, 4, 8, 16 and 24 hours

Secondary Outcomes (4)

• Postoperative pain scores (Numerical rating scale) (0-meaning "no pain" to 10-meaning "worst pain imaginable")

  0, 2, 4, 8, 16 and 24 hours

• Global recovery scoring system (patient satisfaction scale)- QoR-15

  The quality of recovery will be evaluated out of a total of 150 points according to the QoR-15 test to be applied at the portoperative 24th hour.

• Brief Pain Inventory

  postoperative third month

• Hospital Anxiety and Depression Scale (HADS)

  On the morning of surgery and at the 3rd postoperative month

Study Arms (2)

Serratus posterior superior intercostal plane block (SPSIPB)

ACTIVE COMPARATOR

Other: Postoperative analgesia management(SPSIPB)

Erector spinae plane block

ACTIVE COMPARATOR

Other: Postoperative analgesia management(ESPB)

Interventions

Postoperative analgesia management(SPSIPB) OTHER

A high-frequency linear ultrasound probe (GE ML6-15-D Matrix Linear) will be covered with a sterile sheath, and the T3 level will be identified just above the medial border of the scapula. After visualizing the trapezius, rhomboid major, and serratus posterior superior muscles (from superficial to deep), 30 mL of 0.25% bupivacaine (Buvicaine 0.5%®, Polifarma, Tekirdağ, Türkiye) containing 7.5 µg epinephrine (1:200,000) (Adrenalin Bas Galen®; Galen, İstanbul, Türkiye) will be administered as the local anesthetic solution.

Serratus posterior superior intercostal plane block (SPSIPB)

Postoperative analgesia management(ESPB) OTHER

A high-frequency linear ultrasound probe (GE ML6-15-D Matrix Linear) will be covered with a sterile sheath. At the T5 vertebral level, the erector spinae muscle layers and the transverse process of the T5 vertebra, located immediately beneath them, will be identified. After confirming the transverse process, 30 mL of 0.25% bupivacaine (Buvicaine 0.5%®, Polifarma, Tekirdağ, Türkiye) containing 7.5 µg epinephrine (1:200,000) (Adrenalin Bas Galen®; Galen, İstanbul, Türkiye) will be administered as the local anesthetic solution.

Erector spinae plane block

Eligibility Criteria

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

You may qualify if:

• Patients aged 18-65 years with ASA physical status I-III who will undergo elective video-assisted thoracoscopic surgery (VATS) will be included.

You may not qualify if:

• Patients who do not consent to participate in the study
• Patients with coagulopathy
• Patients with a history of local anesthetic allergy or toxicity
• Patients with hepatic or renal failure
• Patients with uncontrolled diabetes
• Patients with uncontrolled hypertension
• Mentally disabled patients
• Patients receiving chronic pain treatment (opioid users)
• Patients using antidepressant medication
• Patients with neuropathic pain
• Mentally disabled patients
• Presence of infection at the injection site
• Pregnant or breastfeeding women, or those with suspected pregnancy

Sponsors & Collaborators

• Bursa City Hospital: lead
• Emre ULUSOY: collaborator

Study Sites (1)

Bursa City Hospital

Bursa, Nilüfer, 16110, Turkey (Türkiye)

RECRUITING

Related Publications (3)

• Mehta S, Jen TTH, Hamilton DL. Regional analgesia for acute pain relief after open thoracotomy and video-assisted thoracoscopic surgery. BJA Educ. 2023 Aug;23(8):295-303. doi: 10.1016/j.bjae.2023.05.001. Epub 2023 Jun 22. No abstract available.

  PMID: 37465231 BACKGROUND

• Wong MKH, Sit AKY, Au TWK. Minimally invasive thoracic surgery: beyond surgical access. J Thorac Dis. 2018 Jun;10(Suppl 16):S1884-S1891. doi: 10.21037/jtd.2018.05.196.

  PMID: 30026975 BACKGROUND

• Steinthorsdottir KJ, Wildgaard L, Hansen HJ, Petersen RH, Wildgaard K. Regional analgesia for video-assisted thoracic surgery: a systematic review. Eur J Cardiothorac Surg. 2014 Jun;45(6):959-66. doi: 10.1093/ejcts/ezt525. Epub 2013 Nov 27.

  PMID: 24288340 BACKGROUND

MeSH Terms

Conditions

Agnosia

Condition Hierarchy (Ancestors)

Perceptual Disorders; Neurobehavioral Manifestations; Neurologic Manifestations; Nervous System Diseases; Signs and Symptoms; Pathological Conditions, Signs and Symptoms

Central Study Contacts

Eralp Çevikkalp

CONTACT

+905054554875; eralpcevikkalp@hotmail.com

Emre ULUSOY

CONTACT

+905379492799; emreulusoy36@gmail.com

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: DOUBLE
• Who Masked: PARTICIPANT, OUTCOMES ASSESSOR
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER GOV
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: assoc prof

Study Record Dates

• First Submitted: November 14, 2025
• First Posted: November 18, 2025
• Study Start: November 15, 2025
• Primary Completion: May 15, 2026
• Study Completion: May 15, 2026
• Last Updated: December 16, 2025

Record last verified: 2025-12

Data Sharing

• IPD Sharing: Will not share

Locations

TU (1)