ESPB vs SPSIP for Postoperative Analgesia After CABG (ESP-SPSIP-CABG)

Kutahya Health Sciences University

Status: Begins enrollment this month

Conditions: Coronary Arterial Disease; Postoperative Pain Management; Coronary Artery Bypass Grafting (CABG) Surgery

Treatments: Procedure: Ultrasound-guided Erector Spinae Plane Block (ESPB); Procedure: Ultrasound-guided Serratus Posterior Superior Intercostal Plane Block (SPSIPB)

Study type: Interventional

Funder types: Other

Identifiers

NCT07388745

KSBÜ-KVC-CABG-ESPB-SPSIPB-2026

Details and patient eligibility

About

This prospective, randomized, active-controlled, double-blind, parallel-group study compares the postoperative analgesic efficacy and safety of ultrasound-guided bilateral Erector Spinae Plane Block (ESPB) versus bilateral Serratus Posterior Superior Intercostal Plane Block (SPSIPB) in adult patients (45-85 years, ASA I-III) undergoing elective coronary artery bypass graft surgery. The primary outcome is postoperative pain intensity assessed by Numeric Rating Scale (NRS) at 2, 4, 8, 16, 24, and 48 hours after surgery. Secondary outcomes include intraoperative fentanyl/remifentanil consumption, postoperative morphine consumption, patient-controlled analgesia (PCA) demand/delivery parameters (if PCA is used), need for rescue analgesics, extubation and mobilization times, peak inspiratory flow measured by incentive spirometry at predefined time points, ICU and hospital length of stay, recovery quality (QoR-15 at 0, 24, and 48 hours), mortality, and block-related adverse events.

Enrollment: 64 estimated patients

Sex: All

Ages: 45 to 85 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Age 45-85 years
• Scheduled for elective coronary artery bypass graft (CABG) surgery
• American Society of Anesthesiologists (ASA) I-II-III
• Patients who provide written informed consent and agree to participate in the study

Exclusion criteria

• Emergency cases
• ASA IV-V
• Known allergy to local anesthetics
• Coagulopathy (platelet count <100,000/mm³, INR >1.5, aPTT >1.5× normal)
• Infection at the block injection site
• Pregnancy
• Patients who do not provide written informed consent or decline to participate after being informed

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Double Blind

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64 participants in 2 patient groups

Erector Spinae Plane Block (ESPB)

Active Comparator group

Description:

Ultrasound-guided bilateral Erector Spinae Plane Block will be performed preoperatively under sedation at the T4-T5 transverse process level. A total of 20 mL of 0.25% bupivacaine will be injected per side (total 40 mL). All participants will receive standardized general anesthesia for CABG and the same postoperative multimodal analgesia protocol.

Treatment:

Procedure: Ultrasound-guided Erector Spinae Plane Block (ESPB)

Serratus Posterior Superior Intercostal Plane Block (SPSIPB)

Experimental group

Description:

Ultrasound-guided bilateral Serratus Posterior Superior Intercostal Plane Block will be performed preoperatively under sedation at the 2nd-3rd intercostal space. A total of 20 mL of 0.25% bupivacaine will be injected per side (total 40 mL). All participants will receive standardized general anesthesia for CABG and the same postoperative multimodal analgesia protocol.

Treatment:

Procedure: Ultrasound-guided Serratus Posterior Superior Intercostal Plane Block (SPSIPB)