Serratus Posterior Superior Intercostal Plane Block Versus Intrathecal Morphine in VATS

NCT07540104 | Recruiting

• 1 other identifier: SPSIPITM1
• Study Type: interventional
• Target: 60
• Locations: 1 country
• Sites: 1

Brief Summary

This study aims to compare the analgesic effects of the serratus posterior superior intercostal plane block and intrathecal morphine in patients undergoing video-assisted thoracoscopic surgery. This is a prospective, randomized, controlled, single-center clinical trial including adult patients undergoing elective thoracoscopic surgery. Participants will be randomly assigned to receive either a serratus posterior superior intercostal plane block or intrathecal morphine before general anesthesia. The primary outcome is cumulative opioid consumption during the first 24 postoperative hours, expressed as intravenous morphine milligram equivalents. Secondary outcomes include pain scores, time to first analgesic request, quality of recovery, and postoperative complications. The study aims to determine whether these two techniques differ in their effectiveness for postoperative pain management.

Conditions

Thoracic Anesthesia; Postoperative Pain; Video Assisted Thoracic Surgery (VATS)

Keywords

Thoracic Surgery, Video-Assisted; Analgesia, Postoperative; Morphine; Injections, Spinal; Nerve Block

Outcome Measures

Primary Outcomes (1)

• Cumulative IV-MME during the first 24 hours after postoperative admission following extubation

  Total opioid consumption during the first 24 postoperative hours is expressed as intravenous morphine milligram equivalents, including patient-controlled analgesia and rescue analgesia.

  24 hours

Secondary Outcomes (16)

• Cumulative IV-MME during the first 12 hours after postoperative admission following extubation

  12 hours

• Postoperative pain scores

  0, 3, 6, 12, 18, and 24 hours postoperatively

• Time to first patient-controlled analgesia demand

  24 hours

• Quality of recovery score

  Preoperative baseline, 24 hours postoperatively, and at discharge

• Postoperative nausea and vomiting

  0, 3, 6, 12, 18, and 24 hours postoperatively

Study Arms (2)

Intrathecal Morphine

EXPERIMENTAL

Participants receive intrathecal morphine before induction of general anesthesia. Preservative-free morphine at 5 µg/kg based on ideal body weight is diluted with 0.9% saline to a total volume of 3 mL and administered intrathecally. All patients subsequently undergo standardized general anesthesia and receive postoperative patient-controlled analgesia with intravenous morphine.

Procedure: Intrathecal Morphine

Serratus Posterior Superior Intercostal Plane Block

EXPERIMENTAL

Participants receive an ultrasound-guided serratus posterior superior intercostal plane block before induction of general anesthesia. A total of 30 milliliters of 0.25 percent bupivacaine with epinephrine is administered into the interfascial plane between the serratus posterior superior muscle and intercostal muscles. All patients subsequently undergo standardized general anesthesia and receive postoperative patient-controlled analgesia with intravenous morphine.

Procedure: Serratus Posterior Superior Intercostal Plane Block

Interventions

Intrathecal Morphine PROCEDURE

Preservative-free morphine at 5 µg/kg based on ideal body weight is diluted with 0.9% saline to a total volume of 3 mL and administered intrathecally before induction of general anesthesia.

Intrathecal Morphine

Serratus Posterior Superior Intercostal Plane Block PROCEDURE

Ultrasound-guided serratus posterior superior intercostal plane block is performed before induction of general anesthesia using 30 milliliters of 0.25 percent bupivacaine with epinephrine injected into the interfascial plane between the serratus posterior superior muscle and intercostal muscles.

Serratus Posterior Superior Intercostal Plane Block

Eligibility Criteria

• Age: 18 Years - 75 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Age between 18 and 75 years
• American Society of Anesthesiologists physical status I to III
• Scheduled for elective video-assisted thoracoscopic surgery, including wedge resection, segmentectomy, or lobectomy

You may not qualify if:

• Refusal to participate
• Pregnancy
• Morbid obesity (body mass index greater than 40 kg per square meter)
• Allergy to study medications
• Neuropsychiatric disorders, cognitive impairment, or inability to communicate
• History of substance abuse
• Active systemic infection or infection at the planned injection site
• Severe cardiac, respiratory, hepatic, renal, or endocrine disease.
• Chronic pain syndrome or ongoing chronic pain treatment
• Emergency surgery or previous ipsilateral VATS or thoracotomy
• Preoperative opioid use: ≥15 mg oral morphine equivalents/day for ≥30 days within the previous 3 months.
• Anticipated need for postoperative mechanical ventilation.
• Contraindications to neuraxial or peripheral regional anesthesia, including anticoagulant therapy, coagulopathy, infection, or relevant anatomical abnormalities.

Sponsors & Collaborators

• Ondokuz Mayıs University: lead

Study Sites (1)

Ondokuz Mayis University

Atakent, Samsun, 55270, Turkey (Türkiye)

RECRUITING

MeSH Terms

Conditions

Pain, Postoperative; Agnosia

Condition Hierarchy (Ancestors)

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

Central Study Contacts

Cengiz Kaya, Prof Dr

CONTACT

+905056793359; cengiz.kaya@omu.edu.tr

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Prof. Dr.

Study Record Dates

• First Submitted: April 9, 2026
• First Posted: April 20, 2026
• Study Start: April 15, 2026
• Primary Completion (Estimated): September 1, 2026
• Study Completion (Estimated): September 30, 2026
• Last Updated: July 30, 2026

Record last verified: 2026-07

Locations

TU (1)