Analgesic Efficacy of SPSIP Block Versus Paravertebral Block Following Thoracotomy

Bursa City Hospital

Status: Enrolling

Conditions: Post-thoracotomy Pain

Treatments: Procedure: Thoracic Paravertebral Block; Procedure: Serratus Posterior Superior Intercostal Plane Block

Study type: Interventional

Funder types: Other

Identifiers

NCT07275047

Bursa City Hospital 13

Details and patient eligibility

About

Thoracotomy causes severe postoperative pain that may impair respiratory function and increase complications. This study compares the postoperative analgesic effectiveness of the serratus posterior superior intercostal plane (SPSIP) block and the paravertebral block in patients undergoing thoracotomy. The aim is to determine whether the newly described serratus posterior superior intercostal plane block can serve as a safe and effective alternative to established techniques.

Full description

Thoracotomy often causes strong postoperative pain because the ribs, muscles, nerves, and pleura are affected during surgery. This pain can make it difficult for patients to breathe well and may increase the chance of lung problems. Paravertebral block is a well-known method for reducing pain after thoracic surgery, but it can sometimes lead to side effects such as low blood pressure or complications related to deeper needle placement.

The serratus posterior superior intercostal plane block is a newer ultrasound-guided technique. In this method, local anesthetic is injected between the serratus posterior superior muscle and the intercostal muscles. Early studies suggest that it may provide wide pain relief, but its effectiveness specifically in thoracotomy patients has not yet been studied.

This randomized study aims to compare the pain-relieving effects of the serratus posterior superior intercostal plane block with those of the paravertebral block after thoracotomy. The goal is to find out whether this new block can be a safe and effective option for postoperative pain management.

Enrollment: 80 estimated patients

Sex: All

Ages: 18 to 65 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Scheduled to undergo thoracotomy
• ASA physical status I-III according to the American Society of Anesthesiologists classification
• Able to understand the study procedures and provide written informed consent

Exclusion criteria

• Declines or is unable to provide informed consent
• Allergy or hypersensitivity to local anesthetics or opioids
• Known or suspected coagulopathy
• Infection at the injection site
• History of thoracic surgery
• Severe cardiovascular disease
• Hepatic or renal failure
• Pregnant, suspected pregnancy, or breastfeeding

Significant neurological or psychiatric disorder that may interfere with study participatio

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Double Blind

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80 participants in 2 patient groups

Group SPSIP

Active Comparator group

Description:

Participants in this arm will receive an ultrasound-guided Serratus Posterior Superior Intercostal Plane Block. The block will be performed preoperatively with the patient in the appropriate position. A local anesthetic solution will be injected between the serratus posterior superior muscle and the intercostal muscles under real-time ultrasound guidance. The technique aims to achieve postoperative analgesia by providing sensory blockade across targeted thoracic dermatomes. No additional regional block will be performed in this group.

Treatment:

Procedure: Serratus Posterior Superior Intercostal Plane Block

Group Paravertebral

Active Comparator group

Description:

Participants in this arm will receive an ultrasound-guided thoracic paravertebral block. The block will be performed preoperatively with the patient in the appropriate position. Under real-time ultrasound guidance, a local anesthetic solution will be injected into the thoracic paravertebral space at the planned level to achieve unilateral somatic and sympathetic nerve blockade. This intervention is intended to provide postoperative analgesia following thoracotomy. No additional regional block will be administered in this group.

Treatment:

Procedure: Thoracic Paravertebral Block