ESPB vs SPSIP for Postoperative Analgesia After CABG

NCT07388745 | Not Yet Recruiting

• 1 other identifier: KSBÜ-KVC-CABG-ESPB-SPSIPB-2026
• Study Type: interventional
• Target: 64
• Locations: 0 countries
• Sites: N/A

Brief Summary

This prospective, randomized, active-controlled, double-blind, parallel-group study compares the postoperative analgesic efficacy and safety of ultrasound-guided bilateral Erector Spinae Plane Block (ESPB) versus bilateral Serratus Posterior Superior Intercostal Plane Block (SPSIPB) in adult patients (45-85 years, ASA I-III) undergoing elective coronary artery bypass graft surgery. The primary outcome is postoperative pain intensity assessed by Numeric Rating Scale (NRS) at 2, 4, 8, 16, 24, and 48 hours after surgery. Secondary outcomes include intraoperative fentanyl/remifentanil consumption, postoperative morphine consumption, patient-controlled analgesia (PCA) demand/delivery parameters (if PCA is used), need for rescue analgesics, extubation and mobilization times, peak inspiratory flow measured by incentive spirometry at predefined time points, ICU and hospital length of stay, recovery quality (QoR-15 at 0, 24, and 48 hours), mortality, and block-related adverse events.

Conditions

Postoperative Pain Management; Coronary Arterial Disease; Coronary Artery Bypass Grafting (CABG) Surgery

Keywords

Coronary Artery Bypass Grafting; Erector Spinae Plane Block; Serratus Posterior Superior Intercostal Plane Block; Regional Anesthesia; Ultrasound-Guided Nerve Block; Postoperative Pain; Numeric Rating Scale

Outcome Measures

Primary Outcomes (1)

• Postoperative pain intensity

  Pain intensity will be assessed using the Numerical Rating Scale (NRS), ranging from 0 to 10, where 0 = no pain and 10 = worst imaginable pain. Higher scores indicate worse pain.

  2, 4, 8, 16, 24, and 48 hours after surgery

Secondary Outcomes (3)

• Cumulative postoperative opioid consumption

  First 24 hours after surgery

• Need for rescue analgesia

  Up to 48 hours after surgery

• Quality of Recovery (QoR-15) score

  Baseline (preoperative), postoperative 24 hours, and 48 hours after surgery

Study Arms (2)

Erector Spinae Plane Block (ESPB)

ACTIVE COMPARATOR

Ultrasound-guided bilateral Erector Spinae Plane Block will be performed preoperatively under sedation at the T4-T5 transverse process level. A total of 20 mL of 0.25% bupivacaine will be injected per side (total 40 mL). All participants will receive standardized general anesthesia for CABG and the same postoperative multimodal analgesia protocol.

Procedure: Ultrasound-guided Erector Spinae Plane Block (ESPB)

Serratus Posterior Superior Intercostal Plane Block (SPSIPB)

EXPERIMENTAL

Ultrasound-guided bilateral Serratus Posterior Superior Intercostal Plane Block will be performed preoperatively under sedation at the 2nd-3rd intercostal space. A total of 20 mL of 0.25% bupivacaine will be injected per side (total 40 mL). All participants will receive standardized general anesthesia for CABG and the same postoperative multimodal analgesia protocol.

Procedure: Ultrasound-guided Serratus Posterior Superior Intercostal Plane Block (SPSIPB)

Interventions

Ultrasound-guided Erector Spinae Plane Block (ESPB) PROCEDURE

Bilateral ultrasound-guided ESPB performed preoperatively under sedation at the T4-T5 transverse process level using 20 mL of 0.25% bupivacaine per side (total 40 mL).

Erector Spinae Plane Block (ESPB)

Ultrasound-guided Serratus Posterior Superior Intercostal Plane Block (SPSIPB) PROCEDURE

Bilateral ultrasound-guided SPSIPB performed preoperatively under sedation at the 2nd-3rd intercostal space using 20 mL of 0.25% bupivacaine per side (total 40 mL).

Serratus Posterior Superior Intercostal Plane Block (SPSIPB)

Eligibility Criteria

• Age: 45 Years - 85 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Age 45-85 years
• Scheduled for elective coronary artery bypass graft (CABG) surgery
• American Society of Anesthesiologists (ASA) I-II-III
• Patients who provide written informed consent and agree to participate in the study

You may not qualify if:

• Emergency cases
• ASA IV-V
• Known allergy to local anesthetics
• Coagulopathy (platelet count \<100,000/mm³, INR \>1.5, aPTT \>1.5× normal)
• Infection at the block injection site
• Pregnancy
• Patients who do not provide written informed consent or decline to participate after being informed

Sponsors & Collaborators

• Kutahya Health Sciences University: lead

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

• Merve Yaman, Assistant Professor

  Kütahya Health Sciences University

  PRINCIPAL INVESTIGATOR

Central Study Contacts

Merve Yaman, Assistant Professor

CONTACT

+905363794742; merve.yaman@ksbu.edu.tr

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
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Assistant Professor

Study Record Dates

• First Submitted: January 25, 2026
• First Posted: February 5, 2026
• Study Start: March 1, 2026
• Primary Completion (Estimated): June 30, 2026
• Study Completion (Estimated): August 31, 2026
• Last Updated: February 5, 2026

Record last verified: 2026-02

Data Sharing

• IPD Sharing: Will not share