Serratus Posterior Superior Plane Block in Minimally Invasive Cardiac Surgery

NCT07420712 | Recruiting

• 1 other identifier: 2025/12/1164
• Study Type: interventional
• Target: 60
• Locations: 1 country
• Sites: 1

Brief Summary

This prospective randomized controlled trial aims to evaluate the effectiveness of the serratus posterior superior intercostal plane block (SPSIPB) as part of a multimodal analgesia strategy in patients undergoing minimally invasive cardiac surgery. Sixty adult ASA III patients scheduled for minimally invasive coronary artery bypass surgery will be randomly assigned to either an SPSIPB group or a control group receiving standard analgesic management without a plane block. The primary outcome is postoperative opioid (tramadol) consumption, while secondary outcomes include intraoperative remifentanil consumption, pain scores at rest and during coughing, time to first rescue analgesia, time to extubation, and lengths of intensive care unit and hospital stay. All patients will receive standardized general anesthesia and postoperative patient-controlled analgesia. Pain intensity will be assessed using the Numeric Rating Scale at predefined postoperative intervals. Postoperative complications such as nausea, vomiting, and atelectasis will be recorded. This study aims to determine whether SPSIPB provides effective opioid-sparing analgesia and improves postoperative recovery parameters in minimally invasive cardiac surgery.

Conditions

Analgesia

Keywords

Serratus posterior superior intercostal plane block; Postoperative pain

Outcome Measures

Primary Outcomes (1)

• Postoperative Opioid Consumption

  Total postoperative opioid consumption measured as cumulative tramadol dose administered via patient-controlled analgesia during the first 24 postoperative hours.

  Within the first 24 hours after surgery

Secondary Outcomes (5)

• Intraoperative Opioid Consumption

  During surgery

• Postoperative Pain Intensity (NRS)

  At 30 minutes, and at 1, 6, 12, 18, and 24 hours after surgery (within the first 24 postoperative hours).

• Time to First Rescue Analgesia

  From the end of surgery to the administration of the first rescue analgesic, assessed within the first 24 postoperative hours

• Time to Extubation

  From completion of surgery to successful tracheal extubation, assessed during the intraoperative and immediate postoperative period.

• Length of Stay in the Intensive Care Unit (ICU)

  From admission to the intensive care unit until ICU discharge, assessed up to 30 days postoperatively.

Study Arms (2)

SPSIPB Group

EXPERIMENTAL

Patients in this arm receive an ultrasound-guided serratus posterior superior intercostal plane block in addition to standard general anesthesia and multimodal postoperative analgesia as part of the perioperative pain management strategy.

Procedure: Serratus Posterior Superior Intercostal Plane Block; Drug: Bupivacaine; Device: Ultrasound

Control Group

NO INTERVENTION

Patients in this arm receive standard general anesthesia and multimodal postoperative analgesia without the use of any regional plane block for perioperative pain management.

Interventions

Bupivacaine DRUG

Bupivacaine was administered as the local anesthetic for the block.

SPSIPB Group

Ultrasound DEVICE

Ultrasound guidance was used for block placement.

SPSIPB Group

Serratus Posterior Superior Intercostal Plane Block PROCEDURE

The serratus posterior superior intercostal plane block is performed under ultrasound guidance before surgery, with the patient in the lateral position. After identification of the third rib and the serratus posterior superior muscle, a local anesthetic solution is injected between the muscle and the rib to provide thoracic wall analgesia as part of a multimodal pain management strategy.

SPSIPB Group

Eligibility Criteria

• Age: 18 Years - 75 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Adults aged 18 years or older
• American Society of Anesthesiologists (ASA) physical status III
• Scheduled for elective minimally invasive coronary artery bypass surgery
• Ability to understand the study procedures and provide written informed consent

You may not qualify if:

• Age under 18 years
• ASA physical status other than III
• Pregnancy
• Emergency surgery
• History of trauma within the previous 24 hours
• Neurological disorders affecting consciousness or decision-making capacity
• Psychiatric disorders affecting decision-making capacity or cooperation
• Known allergy to local anesthetic agents
• Infection or skin disease at the block injection site
• Body mass index greater than 35 kg/m²
• Body weight less than 42 kg
• Coagulation disorders (international normalized ratio \>1.25, activated partial thromboplastin time \>35 seconds, or platelet count \<100,000/µL)

Sponsors & Collaborators

• Kartal Kosuyolu High Speciality Training and Research Hospital: lead

Study Sites (1)

Kosuyolu High Specialization Training and Research Hospital

Istanbul, 34870, Turkey (Türkiye)

RECRUITING

MeSH Terms

Conditions

Agnosia; Pain, Postoperative

Interventions

Bupivacaine; Ultrasonography

Condition Hierarchy (Ancestors)

Perceptual Disorders; Neurobehavioral Manifestations; Neurologic Manifestations; Nervous System Diseases; Signs and Symptoms; Pathological Conditions, Signs and Symptoms; Postoperative Complications; Pathologic Processes; Pain

Intervention Hierarchy (Ancestors)

Anilides; Amides; Organic Chemicals; Aniline Compounds; Amines; Diagnostic Imaging; Diagnostic Techniques and Procedures; Diagnosis

Study Officials

• Mustafa Burgaç, himself

  mustafaburgac@outlook.com

  PRINCIPAL INVESTIGATOR

Central Study Contacts

Mustafa Burgaç, himself

CONTACT

5389848198; mustafaburgac@gmail.com

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Masking Details: Postoperative pain assessments, opioid consumption data, and outcome evaluations are performed by an investigator who is blinded to group assignment.
• Purpose: PREVENTION
• Intervention Model: PARALLEL
• Sponsor Type: OTHER GOV
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Specialist physician

Model Details: Katılımcılar, ultrason eşliğinde serratus posterior superior interkostal plan bloğu uygulanan grup veya bölgesel plan blok uygulanmadan standart multimodal analjezi alan kontrol grubuna rastgele atanacaktır. Sonuçlar iki paralel grup arasında karşılaştırılacaktır.

Study Record Dates

• First Submitted: February 4, 2026
• First Posted: February 19, 2026
• Study Start: July 1, 2025
• Primary Completion (Estimated): July 1, 2026
• Study Completion (Estimated): July 1, 2026
• Last Updated: February 19, 2026

Record last verified: 2026-02

Data Sharing

• IPD Sharing: Will not share

Locations

TU (1)