Postoperative Analgesic Efficacy of SPSIPB in Anterior Cervical Discectomy

NCT07238621 | Active Not Recruiting

• 1 other identifier: 2025-07/24
• Study Type: interventional
• Target: 40
• Locations: 1 country
• Sites: 1

Brief Summary

Anterior cervical discectomy is an operation performed for complaints of pain, numbness or loss of strength due to cervical disc disease. With this operation, pressure due to herniation on the upper neck area, spinal cord or nerve roots is relieved. It is performed by microscopic method from the front of the neck. Nerve blocks reduces opioid consumption in the postoperative period by providing better pain control and therefore has advantages such as fewer side effects and less risk of pulmonary and cardiac complications. In this study; it was aimed to compare the analgesic effectiveness of serratus posterior superior intercostal plane block and erector spinae plane block, and with the control group in the postoperative period in patients who underwent anterior cervical discectomy.

Conditions

Anterior Cervical Discectomy; Serratus Posterior Superior Intercostal Plane Block; Postoperative Pain Management; Postoperative Pain; Cervical Disc Herniation

Keywords

postoperative pain; regional anesthesia; opioid free analgesia; ibuprofen; Serratus Posterior Superior Intercostal Plane Block

Outcome Measures

Primary Outcomes (1)

• Numeric Rating Scale (NRS) Scores

  Numerical rating scale is used for pain assessment. The scores of the numerical rating scale changes between 0 to 10 points. 10 points mean "the most severe pain that the patient ever had". 0 point means "there is no pain." Higher scores mean worse outcome.

  Postoperative 24 hours

Secondary Outcomes (2)

• Total tramadol consumption

  Postoperative 24 hours

• Quality of Recovery scores

  Postoperative 24 hours

Study Arms (2)

Group without peripheral nerve block

ACTIVE COMPARATOR

After the patients are monitored, they will be operated under general anesthesia without peripheral nerve block and intraoperative intravenous analgesics (dexketoprofen 50 mg, paracetamol) will be given.

Procedure: The group treated with intravenous analgesics

Serratus posterior superior intercostal plane block

ACTIVE COMPARATOR

In this study, the intervention will be the SPSIPB. The block will be performed with the patient in the lateral decubitus position.A high-frequency (7-12 MHz) linear transducer will be placed in the transverse plane at the level of the spina scapulae, and the superior medial border of the scapula, the trapezius muscle, the rhomboid muscle, the serratus posterior superior muscle (SPSM), and the second and third ribs will be visualized. Subsequently, a sonovisible needle will be advanced just medial to the scapula, targeting the area between the second and third ribs to reach the fascial plane between the SPSM and the intercostal muscles. After the needle makes gentle contact with the rib, 1-2 mL of saline will be used to confirm the correct plane. A total of 30 mL of 0.25% bupivacaine will then be administered into this fascial plane between the SPSM and the intercostal muscle.In the intraoperative period, intravenous analgesics (dexketoprofen 50 mg, paracetamol 1000 mg) will be given.

Procedure: Serratus posterior superior intercostal plane block

Interventions

The group treated with intravenous analgesics PROCEDURE

In the postoperative period a ibuprofen dose of 400 mg every 8 hours were administered iv for multimodal analgesia

Group without peripheral nerve block

Serratus posterior superior intercostal plane block PROCEDURE

Serratus posterior superior intercostal plane block will be performed on the patients using 30 ml of 0.25% bupivacaine under ultrasound guidance.Additionally, in the postoperative period a paracetamol dose of 1 g every 8 hours and a dexketoprofen dose of 50 mg twice daily were administered iv for multimodal analgesia.

Serratus posterior superior intercostal plane block

Eligibility Criteria

• Age: 18 Years - 80 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Adult patients over 18 years of age who underwent percutaneous nephrolithotomy under general anesthesia and were I-II-III according to the American Society of Anesthesiologists (ASA) risk classification were included in the study.

You may not qualify if:

• patients who did not give consent,
• patients with coagulopathy,
• patients with signs of infection at the block application site,
• patients using anticoagulants,
• patients with known allergies to any of the study drugs,
• patients with unstable hemodynamics,
• patients who could not cooperate during postoperative pain assessment
• patients who wanted to withdraw from the study,
• patients with alcohol and drug addiction,
• patients with musculoskeletal abnormalitie

Sponsors & Collaborators

• Cumhuriyet University: lead

Study Sites (1)

Sivas Cumhuriyet University

Sivas, Sivas, 58140, 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

• ONUR AVCI

  Sivas Cumhuriyet University School of Medicine, Anesthesiology and Reanimation

  PRINCIPAL INVESTIGATOR

• ZEYNEP M DEMİRCİ

  Sivas Cumhuriyet University School of Medicine, Anesthesiology and Reanimation

  STUDY CHAIR

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: November 15, 2025
• First Posted: November 20, 2025
• Study Start: September 30, 2025
• Primary Completion (Estimated): October 10, 2026
• Study Completion (Estimated): November 30, 2026
• Last Updated: February 25, 2026

Record last verified: 2026-02

Data Sharing

• IPD Sharing: Will not share

Locations

TU (1)