Comparison of Erector Spinae Plane Block and Serratus Posterior Superior Intercostal Plane Block in Postoperative Pain Management After Coronary Artery Bypass Grafting

NCT07287761 | Recruiting

• 1 other identifier: 496
• Study Type: observational
• Target: 60
• Locations: 1 country
• Sites: 1

Brief Summary

Coronary Artery Bypass Grafting (CABG) is a common surgical procedure for ischemic heart disease, but it often leads to severe acute and chronic postoperative pain, which can delay recovery and reduce patient comfort. Effective pain management is crucial to prevent pulmonary complications and long hospital stays. Peripheral nerve blocks are increasingly used to reduce opioid consumption and improve patient satisfaction after major surgery. This prospective, observational study aims to compare the effectiveness and safety of two different regional anesthesia techniques, the Erector Spinae Plane Block (ESPB) and the Serratus Posterior Superior Intercostal Plane Block (SPSIPB), in managing postoperative pain in patients undergoing CABG via median sternotomy. Patients aged 18-80 years, classified as ASA II-III, who are scheduled for elective CABG will be included. The choice of block technique (ESPB or SPSIPB) will be determined by the operating anesthesiologist based on the visibility of anatomical structures (transverse processes) under ultrasound guidance. All patients will receive the same general anesthesia and be managed postoperatively with Intravenous Patient-Controlled Analgesia (PCA). The main goal is to determine which block provides optimal pain control, measured by the time to first rescue analgesia and pain scores (NRS) at various time points after extubation. Secondary outcomes include intraoperative opioid consumption, total PCA usage, extubation time, and the incidence of opioid-related side effects. The findings will help optimize pain protocols for cardiac surgery patients.

Conditions

Coronary Artery Bypass Graft (CABG); Postoperative Pain After Thoracic Surgery

Keywords

Erector Spinae Plane Block (ESPB); Regional Anesthesia; Post-CABG Pain; Postoperative pain; Coronary Artery Bypass Graft Surgery; Serratus Posterior Superior Intercostal Plane Block (SPSIPB)

Outcome Measures

Primary Outcomes (1)

• Total Opioid Consumption in the Perioperative Period

  The cumulative dose of all opioids administered (Intraoperative Fentanyl and Post-Extubation Tramadol via PCA and rescue doses of Morphine) will be calculated in Morphine Equivalent Dose (mg).

  Up to 24 hours post-extubation

Study Arms (2)

ESPB Group

Erector Spinae Plane Block (ESPB) with Bupivacaine

SPSIPB Group

Serratus Posterior Superior Intercostal Plane Block (SPSIPB) with Bupivacaine

Eligibility Criteria

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

Study Population

The study population consists of adult patients (18 to 80 years) classified as ASA Physical Status Class II or III, who are scheduled to undergo elective Coronary Artery Bypass Grafting (CABG) requiring median sternotomy at the University of Health Sciences Ankara Training and Research Hospital.

You may qualify if:

• Patients scheduled for elective Coronary Artery Bypass Grafting (CABG) via median sternotomy.
• Age between 18 and 80 years.
• Classification of American Society of Anesthesiologists (ASA) Physical Status Class II or III.
• Patients who provide written and verbal informed consent to participate in the study.

You may not qualify if:

• Patients who do not provide consent.
• Age older than 80 years or ASA Physical Status Class \> III.
• Patients who do not understand the Numerical Rating Scale (NRS) or have communication difficulties.
• Patients with a known history of coagulation disorders or bleeding disorders.
• Patients with skin infection at the site of peripheral nerve block application.
• Patients with Morbid Obesity (Body Mass Index BMI\>35 kg/m2).
• Patients with chronic pain, opioid or substance dependence, or who use chronic analgesics.
• Patients with known allergy to local anesthetics.
• Patients with liver or kidney function disorders.
• Patients with a history of previous median sternotomy operation.
• Patients undergoing emergency surgery.

Sponsors & Collaborators

• Ankara Education and Research Hospital: lead

Study Sites (1)

Ankara Training and Research Hospital

Ankara, Altındag, 06230, Turkey (Türkiye)

RECRUITING

Related Publications (4)

• 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

• Rothaug J, Zaslansky R, Schwenkglenks M, Komann M, Allvin R, Backstrom R, Brill S, Buchholz I, Engel C, Fletcher D, Fodor L, Funk P, Gerbershagen HJ, Gordon DB, Konrad C, Kopf A, Leykin Y, Pogatzki-Zahn E, Puig M, Rawal N, Taylor RS, Ullrich K, Volk T, Yahiaoui-Doktor M, Meissner W. Patients' perception of postoperative pain management: validation of the International Pain Outcomes (IPO) questionnaire. J Pain. 2013 Nov;14(11):1361-70. doi: 10.1016/j.jpain.2013.05.016. Epub 2013 Sep 7.

  PMID: 24021577 BACKGROUND

• Wang AH, Juan AH, Ko KD, Tsai PF, Zare H, Dell'Orso S, Sartorelli V. The Elongation Factor Spt6 Maintains ESC Pluripotency by Controlling Super-Enhancers and Counteracting Polycomb Proteins. Mol Cell. 2017 Oct 19;68(2):398-413.e6. doi: 10.1016/j.molcel.2017.09.016. Epub 2017 Oct 12.

  PMID: 29033324 BACKGROUND

• Mazzeffi M, Khelemsky Y. Poststernotomy pain: a clinical review. J Cardiothorac Vasc Anesth. 2011 Dec;25(6):1163-78. doi: 10.1053/j.jvca.2011.08.001. Epub 2011 Sep 29. No abstract available.

  PMID: 21955825 BACKGROUND

MeSH Terms

Conditions

Pain, Postoperative

Condition Hierarchy (Ancestors)

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

Central Study Contacts

Abdullah KONAN, M.D

CONTACT

+903125953000; drkonan44@gmail.com

Suna AKIN TAKMAZ, M.D

CONTACT

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: PROSPECTIVE
• Sponsor Type: OTHER GOV
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Principal Investigator

Study Record Dates

• First Submitted: November 25, 2025
• First Posted: December 17, 2025
• Study Start: November 1, 2025
• Primary Completion: March 1, 2026
• Study Completion: May 1, 2026
• Last Updated: December 17, 2025

Record last verified: 2025-12

Data Sharing

• IPD Sharing: Will share
• Shared Documents: STUDY PROTOCOL, SAP
• Time Frame: Data will be made available beginning 6 months after publication of the main results in a peer-reviewed journal and will remain available for a period of 5 years after the publication date.
• Access Criteria: Access will be granted to researchers who submit a methodologically sound proposal for research purposes. The requester must sign a Data Sharing Agreement guaranteeing the use of the data will be restricted to the proposed research and that the anonymity of participants will be protected. Data will be provided in an anonymized, de-identified format.

Locations

TU (1)