SPSIP vs ESP Block for Analgesia After Rib Fracture Surgery

NCT07553208 | Not Yet Recruiting

• 1 other identifier: esp-spsıp-Rib
• Study Type: interventional
• Target: 60
• Locations: 1 country
• Sites: 1

Brief Summary

This prospective interventional study aims to evaluate and compare the analgesic efficacy of the Serratus Posterior Superior Intercostal Plane (SPSIP) block and the Erector Spinae Plane (ESP) block in patients undergoing surgical stabilization of rib fractures. The primary outcome is the Visual Analog Scale (VAS) score within the first 24 hours after surgery. Secondary outcomes include total opioid consumption, requirement for rescue analgesia, block performance time, block-related and systemic side effects (hematoma, pneumothorax, local anesthetic systemic toxicity, vascular puncture, and infection), patient satisfaction assessed using a Likert scale, and quality of recovery assessed using the QoR-15 questionnaire.

Conditions

Rib Fracture; Thoracic Trauma; Postoperative Pain

Keywords

serratus posterior superior intercostal plane block; spsıp block; erector spine plane block; esp; rib fixation; regioanl anethesia

Outcome Measures

Primary Outcomes (1)

• Postoperative pain intensity assessed using the Visual Analog Scale (VAS)

  Postoperative pain intensity (VAS score) Postoperative pain will be assessed using the visual analog scale (VAS), ranging from 0 to 10, where 0 indicates no pain and 10 indicates the worst imaginable pain. Higher scores represent greater pain intensity. Measurements will be recorded at predefined time points within the first 24 hours after surgery.

  0, 1, 4, 8, 12, and 24 hours after surgery

Secondary Outcomes (7)

• Total opioid consumption via patient-controlled analgesia (PCA)

  Within the first 24 hours postoperatively

• Requirement for rescue analgesia

  Within the first 24 hours postoperatively

• Block performance time

  During the block procedure (intraoperative period)

• Block-related and systemic side effects

  Within the first 24 hours postoperatively

• Patient and Surgeon satisfaction assessed using a Likert scale

  At 24 hours postoperatively

Study Arms (2)

Serratus Posterior Superior Intercostal Plane Block (SPSIP)

ACTIVE COMPARATOR

Serratus Posterior Superior Intercostal Plane

Procedure: Serratus Posterior Superior Intercostal Plane (SPSIP)

Erector Spinae Plane Block (ESP)

ACTIVE COMPARATOR

Erector Spinae Plane Block

Procedure: Erector Spinae Plane Block (ESP)

Interventions

Erector Spinae Plane Block (ESP) PROCEDURE

Patients in this group will receive an ultrasound-guided Erector Spinae Plane Block (ESP) with 30 mL of 0.25% bupivacaine hydrochloride injected into the fascial plane between the erector spinae muscle and the fifth vertebral transverse processes, 30 minutes before surgery.

Erector Spinae Plane Block (ESP)

Serratus Posterior Superior Intercostal Plane (SPSIP) PROCEDURE

Patients in this group will receive an ultrasound-guided Serratus Posterior Superior Intercostal Plane (SPSIP) block with 30 mL of 0.25% bupivacaine hydrochloride injected into the fascial plane between the serratus posterior superior muscle and the third rib, 30 minutes before surgery.

Serratus Posterior Superior Intercostal Plane Block (SPSIP)

Eligibility Criteria

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

You may qualify if:

• Patients aged 18-65 years
• ASA physical status I-III
• Scheduled for elective video-assisted thoracoscopic surgery
• Body mass index (BMI) between 18 and 35 kg/m²
• Ability to understand and use the patient-controlled analgesia (PCA) device
• Ability to provide written informed consent

You may not qualify if:

• Refusal to participate
• Allergy to local anesthetics
• Infection at the injection site
• Coagulopathy or ongoing anticoagulant therapy
• Chronic opioid use or opioid dependence
• Severe hepatic or renal insufficiency
• Pregnancy or breastfeeding
• Cognitive impairment or inability to communicate pain scores
• Body mass index (BMI) \<18 or \>35 kg/m²

Sponsors & Collaborators

• Antalya City Hospital: lead

Study Sites (1)

Antalya City Hospitial, Ministry of Health, Turkey

Antalya, Turkey (Türkiye)

Location

MeSH Terms

Conditions

Rib Fractures; Pain, Postoperative

Condition Hierarchy (Ancestors)

Fractures, Bone; Wounds and Injuries; Thoracic Injuries; Postoperative Complications; Pathologic Processes; Pathological Conditions, Signs and Symptoms; Pain; Neurologic Manifestations; Signs and Symptoms

Study Officials

• MUSTAFA KILIN

  ANTALYA CİTY HOSPİTAL, MİNİSTRY OF HEALTH, TURKEY

  PRINCIPAL INVESTIGATOR

Central Study Contacts

Mustafa KILIN, Consultant Anesthesiologist

CONTACT

+905464569218; mustafa.kilin90@gmail.com

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: NON RANDOMIZED
• Masking: NONE
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Consultant Anesthesiologist

Study Record Dates

• First Submitted: April 21, 2026
• First Posted: April 27, 2026
• Study Start (Estimated): November 15, 2026
• Primary Completion (Estimated): June 15, 2028
• Study Completion (Estimated): June 15, 2028
• Last Updated: May 5, 2026

Record last verified: 2026-04

Data Sharing

• IPD Sharing: Will not share

Locations

TU (1)