Minimum Effective Volume of Bupivacaine for Serratus Posterior Superior Intercostal Plane Block in Video-Assisted Thoracoscopic Surgery

NCT07446959 | Recruiting

• 1 other identifier: Bursa City Hospital 15
• Study Type: interventional
• Target: 27
• Locations: 1 country
• Sites: 1

Brief Summary

This study aims to determine the minimum effective volume of bupivacaine required for the serratus posterior superior intercostal plane (SPSIP) block in patients undergoing video-assisted thoracoscopic surgery (VATS). The SPSIP block is an ultrasound-guided regional anesthesia technique used to provide postoperative pain relief after thoracic surgery. Using a stepwise dose-adjustment method, the volume of local anesthetic will be increased or decreased based on the effectiveness of the block in each patient. The main outcome of the study is to identify the volume that provides effective pain control in 50% of patients. The results may help optimize pain management while minimizing drug exposure.

Conditions

Postoperative Pain Management; Video-assisted Thoracoscopic Surgery (VATS)

Keywords

SPSIP Block; Regional Anesthesia; Dose-Finding Study; Dixon Up-and-Down Method; Thoracic Analgesia

Outcome Measures

Primary Outcomes (1)

• Median Effective Volume (ED50) of 0.5% Bupivacaine for Successful SPSIP Block

  The median effective volume (ED50) of 0.5% bupivacaine required to achieve successful postoperative analgesia following ultrasound-guided serratus posterior superior intercostal plane block, determined using the Dixon up-and-down sequential allocation method.

  Within the first 30 minutes after block performance

Secondary Outcomes (5)

• Postoperative Pain Scores (NRS)

  Up to 24 hours postoperatively

• Postoperative Morphine Consumption via Patient-Controlled Analgesia (PCA)

  First 24 hours after surgery

• Postoperative Adverse Effects

  Up to 24 hours postoperatively

• Quality of Recovery Score (QoR-15)

  24 hours after surgery

• Postoperative Pulmonary Function Parameters

  Preoperative baseline and 24 hours after surgery

Study Arms (1)

Serratus Posterior Superior Intercostal Plane Block (SPSIPB)

EXPERIMENTAL

Participants receive an ultrasound-guided serratus posterior superior intercostal plane block (SPSIPB) with 0.5% bupivacaine before video-assisted thoracoscopic surgery (VATS). The injected volume is determined using the Dixon up-and-down sequential allocation method, starting from an initial volume and adjusted by 2 mL increments or decrements based on block success or failure in the preceding patient. Block success is assessed by a blinded outcome assessor according to predefined analgesic criteria.

Other: Ultrasound-Guided Serratus Posterior Superior Intercostal Plane Block

Interventions

Ultrasound-Guided Serratus Posterior Superior Intercostal Plane Block OTHER

Ultrasound-guided serratus posterior superior intercostal plane block performed prior to general anesthesia in patients undergoing video-assisted thoracoscopic surgery (VATS). A 0.5% bupivacaine solution is injected, and the volume is adjusted in 2 mL increments according to the Dixon up-and-down sequential allocation method to determine the median effective volume (ED50).

Serratus Posterior Superior Intercostal Plane Block (SPSIPB)

Eligibility Criteria

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

You may qualify if:

• Age 18 years or older
• Scheduled for elective video-assisted thoracoscopic surgery (VATS)
• American Society of Anesthesiologists (ASA) physical status I-III
• Planned to receive ultrasound-guided serratus posterior superior intercostal plane block for postoperative analgesia
• Ability to provide written informed consent

You may not qualify if:

• Refusal to participate in the study
• Known allergy or contraindication to local anesthetics
• Infection at the block injection site
• Coagulation disorders or anticoagulant therapy contraindicating regional anesthesia
• Severe respiratory insufficiency
• Chronic opioid use or chronic pain syndrome
• Pregnancy
• Inability to cooperate or communicate postoperative pain scores

Sponsors & Collaborators

• Bursa City Hospital: lead
• Ulusoy, Emre, M.D.: collaborator

Study Sites (1)

T.C. Sağlık Bakanlığı Bursa Şehir Hastanesi

Bursa, 16250, Turkey (Türkiye)

RECRUITING

Central Study Contacts

emre ulusoy

CONTACT

+905379492799; emreulusoy36@gmail.com

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: NA
• Masking: NONE
• Purpose: TREATMENT
• Intervention Model: SEQUENTIAL
• Sponsor Type: OTHER GOV
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: prof.

Model Details: Sequential dose-adjustment design using the Dixon up-and-down method, in which local anesthetic volume is increased or decreased in fixed 2 mL steps based on the success or failure of the preceding block.

Study Record Dates

• First Submitted: February 26, 2026
• First Posted: March 3, 2026
• Study Start: March 15, 2026
• Primary Completion: May 11, 2026
• Study Completion (Estimated): July 15, 2026
• Last Updated: May 12, 2026

Record last verified: 2026-05

Data Sharing

• IPD Sharing: Will not share

Locations

TU (1)