Two-Point Versus Single-Point Serratus Anterior Plane Block for Post-Thoracoscopic Surgery Analgesia

NCT07700823 | Not Yet Recruiting

• 1 other identifier: 2026LY0735
• Study Type: observational
• Target: 88
• Locations: 0 countries
• Sites: N/A

Brief Summary

Postoperative pain remains a common clinical challenge in patients undergoing video-assisted thoracoscopic surgery (VATS), impairing early recovery and increasing opioid consumption. The serratus anterior plane block (SAPB) is a widely used regional analgesic technique for thoracic surgery, but conventional single-point injection may have limited spread of local anesthetics, resulting in suboptimal analgesia in some patients. Preliminary anatomical evidence suggests that two-point combined SAPB may achieve wider dermatomal coverage and better analgesic efficacy. This is a single-center, prospective observational cohort study conducted at Shanghai Pulmonary Hospital, China. A total of 88 adult patients scheduled for elective unilateral VATS will be consecutively enrolled and naturally assigned to either the two-point combined SAPB group (injection at the 3rd and 5th rib levels, total 30 ml local anesthetic) or the single-point SAPB group (injection at the 5th rib level, 30 ml local anesthetic) according to routine clinical practice. The primary outcome is the verbal rating scale (VRS) pain score on coughing at 24 hours postoperatively. Secondary outcomes include resting and dynamic pain scores at multiple time points, cumulative opioid consumption at 24 and 48 hours, incidence of postoperative nausea and vomiting, block-related complications, length of hospital stay, and Quality of Recovery-15 (QoR-15) scores. This study aims to provide clinical evidence for optimizing perioperative analgesic strategies for thoracoscopic surgery.

Conditions

Lung Cancer; Pain; Video-Assisted Thoracoscopic Surgery; Serratus Anterior Plane Block

Outcome Measures

Primary Outcomes (1)

• Verbal Rating Scale (VRS) Pain Score on Coughing at 24 Hours Postoperatively

  Dynamic pain intensity assessed using a 0-10 verbal rating scale (0 = no pain, 10 = worst imaginable pain) when the patient performs coughing.

  24 hours after surgery

Secondary Outcomes (5)

• Resting Verbal Rating Scale (VRS) Pain Scores

  1 hour, 6 hours, 12 hours, 24 hours, 48 hours after surgery

• Cumulative Postoperative Opioid Consumption

  24 hours and 48 hours after surgery

• Incidence of Postoperative Nausea and Vomiting (PONV)

  Within 48 hours after surgery

• Incidence of Block-Related Adverse Events

  Within 48 hours after surgery

• Quality of Recovery-15 (QoR-15) Score

  24 hours and 48 hours after surgery

Study Arms (2)

Two-Point SAPB Group

Patients in this cohort receive ultrasound-guided two-point combined serratus anterior plane block for perioperative analgesia as part of routine clinical practice. A total of 30 mL local anesthetic is administered, with 15 mL injected deep to the serratus anterior muscle at the 3rd rib level and 15 mL at the 5th rib level.

Procedure: Two-Point Serratus Anterior Plane Block

Single-Point SAPB Group

Patients in this cohort receive ultrasound-guided single-point serratus anterior plane block for perioperative analgesia as part of routine clinical practice. A total of 30 mL local anesthetic is injected deep to the serratus anterior muscle at the 5th rib level in a single administration.

Procedure: Single-Point Serratus Anterior Plane Block

Interventions

Two-Point Serratus Anterior Plane Block PROCEDURE

Ultrasound-guided fascial plane block for perioperative thoracic analgesia. Local anesthetic is deposited deep to the serratus anterior muscle at two separate rib levels, with equal volume split between the 3rd and 5th intercostal spaces.

Also known as: Two-Point SAPB; Double-Point Serratus Plane Block

Two-Point SAPB Group

Single-Point Serratus Anterior Plane Block PROCEDURE

Ultrasound-guided fascial plane block for perioperative thoracic analgesia. A single bolus of local anesthetic is deposited deep to the serratus anterior muscle at the 5th intercostal level.

Also known as: ingle-Point SAPB; Conventional Serratus Plane Block

Single-Point SAPB Group

Eligibility Criteria

• Age: 18 Years - 85 Years
• Sex: all
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

This single-center, prospective observational cohort study is conducted at Shanghai Pulmonary Hospital, Tongji University School of Medicine, China. It enrolls adults aged 18-85 years with ASA physical status I-III, scheduled for elective unilateral video-assisted thoracoscopic surgery and planned for ultrasound-guided serratus anterior plane block as routine perioperative analgesia.Eligible participants will be consecutively enrolled after written informed consent. Patients are naturally assigned to two cohorts based on the block regimen selected by the attending anesthesiologist in standard clinical practice, with a target total sample size of 88 (\~44 per cohort). No study-initiated randomization or treatment intervention is applied; all clinical management follows institutional routine protocols.

You may qualify if:

• Aged 18 to 85 years at enrollment, regardless of sex
• American Society of Anesthesiologists (ASA) physical status grade I to III
• Scheduled for elective unilateral video-assisted thoracoscopic surgery
• Planned to receive ultrasound-guided SAPB for routine perioperative analgesia
• Able to understand study procedures and provide written informed consent

You may not qualify if:

• Local infection or skin lesion at the block puncture site
• Known hypersensitivity or allergy to amide local anesthetics
• Preexisting sensory abnormality in the chest wall surgical area
• Chronic opioid use for \> 3 months, history of chronic pain syndrome, or history of opioid abuse
• Severe coagulopathy (international normalized ratio \> 1.5 or platelet count \< 80 × 10⁹/L)
• Cognitive impairment or inability to cooperate with postoperative pain assessment
• Refusal to provide written informed consent

Sponsors & Collaborators

• Shiyou Wei: lead

MeSH Terms

Conditions

Lung Neoplasms; Pain

Condition Hierarchy (Ancestors)

Respiratory Tract Neoplasms; Thoracic Neoplasms; Neoplasms by Site; Neoplasms; Lung Diseases; Respiratory Tract Diseases; Neurologic Manifestations; Signs and Symptoms; Pathological Conditions, Signs and Symptoms

Study Officials

• Shiyou Wei

  Tongji University Affiliated Shanghai Pulmonary Hospital

  PRINCIPAL INVESTIGATOR

Central Study Contacts

Shiyou Wei

CONTACT

15601680288; lovewishyou@tongji.edu.cn

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: PROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: SPONSOR INVESTIGATOR
• PI Title: Attending Physician

Study Record Dates

• First Submitted: July 8, 2026
• First Posted: July 14, 2026
• Study Start: August 1, 2026
• Primary Completion (Estimated): September 1, 2026
• Study Completion (Estimated): September 5, 2026
• Last Updated: July 14, 2026

Record last verified: 2026-07

Data Sharing

• IPD Sharing: Will not share