Analgesic Effectiveness of SPSIPB Versus Thoracic Epidural and Systemic Opioid Analgesia After VATS (SPSIPB-VATS)

NCT07238348 | Not Yet Recruiting

• 2 other identifiers: 2024/1762024/276
• Study Type: observational
• Target: 120
• Locations: 0 countries
• Sites: N/A

Brief Summary

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.

Conditions

Postoperative Pain Management; Video-assisted Thoracoscopic Surgery (VATS); Thoracic Epidural Analgesia; Serratus Posterior Superior Intercostal Plane Block

Keywords

Serratus Posterior Superior Intercostal Plane Block; Thoracic Epidural Analgesia; Systemic Opioid Analgesia; Video-Assisted Thoracoscopic Surgery; Opioid Consumption; Pain Management

Outcome Measures

Primary Outcomes (1)

• Opioid Consumption

  Total Opioid Consumption at 24 Hours

  24 hours postoperatively

Secondary Outcomes (8)

• Pain Scores

  0, 1, 2, 6, 12, and 24 hours after surgery

• Need for Rescue Analgesia

  First 24 hours postoperatively

• Incidence of Postoperative Nausea and Vomiting (PONV)

  First 24 hours postoperatively

• Heart Rate (beats per minute)

  Intraoperative and first 24 hours postoperative

• Quality of Recovery Score (QoR-15)

  Preoperative baseline and 24 hours postoperative

Study Arms (3)

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.

Eligibility Criteria

• Age: 18 Years - 75 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

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.

You may qualify if:

• Adults aged 18-75 years
• Scheduled for elective video-assisted thoracoscopic surgery (VATS)
• ASA physical status I-III
• Ability to understand study procedures and provide written informed consent
• Hemodynamically stable preoperatively

You may not qualify if:

• Known allergy or contraindication to local anesthetics or study medications
• Coagulopathy or use of anticoagulants not suitable for regional anesthesia
• Local infection or skin lesions at the injection site
• Severe pulmonary disease (e.g., severe COPD, uncontrolled asthma)
• Chronic opioid use or chronic pain disorders
• Neurological or psychiatric disorders impairing cooperation
• Pregnancy or breastfeeding
• BMI \> 35 kg/m²
• Conversion from VATS to thoracotomy
• Inability to comply with postoperative assessments

Sponsors & Collaborators

• Karadeniz Technical University: lead

Related Publications (3)

• 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.

  PMID: 37852626 BACKGROUND

• 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.

  PMID: 36883093 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.

  PMID: 40275145 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

Ali AKDOGAN, MD

CONTACT

+905322605414; draliakdogan@yahoo.com

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: PROSPECTIVE
• Target Duration: 1 Day
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Prof Dr

Study Record Dates

• First Submitted: November 14, 2025
• First Posted: November 20, 2025
• Study Start: December 15, 2025
• Primary Completion: May 15, 2026
• Study Completion (Estimated): August 15, 2026
• Last Updated: November 20, 2025

Record last verified: 2025-11

Data Sharing

• IPD Sharing: Will not share