Comparison of the Rhomboid Intercostal Block and Serratus Posterior Superior Intercostal Plane Block

NCT07650877 | Recruiting

• 1 other identifier: E.Kurul-E2-26-14830
• Study Type: interventional
• Target: 90
• Locations: 1 country
• Sites: 1

Brief Summary

Video-assisted thoracic surgery (VATS) is widely performed for the management of various thoracic pathologies and is generally associated with reduced surgical trauma compared with open thoracotomy. Nevertheless, patients may still experience considerable postoperative pain, which can adversely affect respiratory function, mobilization, and recovery. Various regional analgesic techniques have been incorporated into multimodal pain management strategies for VATS, including thoracic paravertebral block (TPVB), erector spinae plane block (ESPB), intercostal nerve block, serratus anterior plane block (SAPB), rhomboid intercostal block (RIB), and serratus posterior superior intercostal plane block (SPSIPB). Among these approaches, ultrasound-guided TPVB has traditionally been regarded as a reference regional analgesic technique. More recently, interfascial plane blocks have gained increasing attention because of their technical simplicity and favorable safety profile. RIB and SPSIPB are two novel interfascial plane blocks that may provide effective postoperative analgesia following thoracic surgery. The present study aims to compare the analgesic efficacy of RIB and SPSIPB in patients undergoing VATS and to evaluate their impact on postoperative pain outcomes.

Conditions

Pain, Postoperative; Multimodal Analgesia; Rhomboid Intercostal Block; Serratus Posterior Superior Intercostal Plane Block; Thoracic Surgery, Video-Assisted

Outcome Measures

Primary Outcomes (1)

• Surgical Pain Scores

  Surgical pain will be assessed at rest and while coughing using the visual analog scale on a scale from 0mm (no pain) to 100mm (worst pain). Pain assessment will be done at 1st, 6th, 12th, and 24th hours after surgery.

  24 hours after surgery

Secondary Outcomes (2)

• Shoulder Pain Scores

  24 hours after surgery

• Intraoperative remifentanil consumption

  During the intraoperative period

Study Arms (2)

Rhomboid Intercostal Block

ACTIVE COMPARATOR

For patients scheduled to receive a Rhomboid Intercostal Block (RIB), after sonographic identification of the relevant anatomical structures, the block needle is advanced using an in-plane ultrasound-guided technique beneath the rhomboid muscle until contact with the rib is achieved. Following hydrodissection with 2 mL of normal saline to confirm correct needle placement, 30 mL of 0.25% bupivacaine is injected into the interfascial plane.

Drug: Rhomboid Intercostal Block

Serratus Posterior Superior Intercostal Plane Block

ACTIVE COMPARATOR

For patients scheduled to receive a Serratus Posterior Superior Intercostal Plane Block (SPSIPB), after sonographic identification of the relevant anatomical structures, the block needle is advanced using an in-plane ultrasound-guided technique beneath the serratus posterior superior muscle until contact with the rib is achieved. Following hydrodissection with 2 mL of normal saline to confirm correct needle placement, 30 mL of 0.25% bupivacaine is injected into the interfascial plane.

Drug: Serratus Posterior Superior Intercostal Plane Block

Interventions

Rhomboid Intercostal Block DRUG

Rhomboid intercostal block will be applied to the patients under real-time ultrasound guidance.

Rhomboid Intercostal Block

Serratus Posterior Superior Intercostal Plane Block DRUG

Serratus posterior superior intercostal plane block will be applied to the patients under real-time ultrasound guidance.

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:

• Patients undergoing elective VATS
• Patients aged 18-75 years
• Patients with ASA (American Society of Anesthesiologists) class I-III
• Patients who have given informed consent

You may not qualify if:

• Patients allergic to local anesthetics
• Patients with bleeding disorders or those undergoing anticoagulant therapy
• Pregnant and breastfeeding women
• Patients with impaired consciousness, inability to communicate, or mental/cognitive impairment
• Patients who refuse block application
• Patients with infection in the area where the block will be applied

Sponsors & Collaborators

• Ankara City Hospital Bilkent: lead

Study Sites (1)

Ankara City Hospital

Çankaya, Ankara, 06290, Turkey (Türkiye)

RECRUITING

MeSH Terms

Conditions

Pain, Postoperative

Condition Hierarchy (Ancestors)

Postoperative Complications; Pathologic Processes; Pathological Conditions, Signs and Symptoms; Pain; Neurologic Manifestations; Signs and Symptoms

Central Study Contacts

Emine Nilgün Zengin, Associate Professor

CONTACT

00905063370548; nilbavullu@gmail.com

Hülya Yiğit, Associate Professor

CONTACT

00905054853939; yigitozay@hotmail.com

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: Principal İnvestigator

Study Record Dates

• First Submitted: June 11, 2026
• First Posted: June 16, 2026
• Study Start: June 15, 2026
• Primary Completion (Estimated): November 20, 2026
• Study Completion (Estimated): November 30, 2026
• Last Updated: June 16, 2026

Record last verified: 2026-06

Locations

TU (1)