Comprasion of SPSIP and Rhomboid Intercostal Plan Blocks on VATS

June 2, 2026 updated by: Oguz Gundogdu, Cumhuriyet University

Comparison of the Analgesic Efficacy of Rhomboid Intercostal Plane Block and Serratus Posterior Superior Intercostal Plane Block on Postoperative Pain in Patients Undergoing Video-Assisted Thoracoscopic Surgery

This study aimed to compare rhomboid intercostal plane block and serratus posterior superior intercostal plane block (SPSIPB) to determine the most suitable technique for maintaining postoperative analgesia in video-assisted thoracoscopic surgeries (VATS).

Study Overview

Status

Status

Indicates the current recruitment status or the expanded access status.
Recruiting

Conditions

Conditions

The disease, disorder, syndrome, illness, or injury that is being studied. On ClinicalTrials.gov, conditions may also include other health-related issues, such as lifespan, quality of life, and health risks.

Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.

Detailed Description

Patients were randomly allocated into two groups: RIB and SPSIPB. All patients received postoperative paracetamol and dexketoprofen, and intravenous tramadol hydrochloride was administered via patient-controlled analgesia. Postoperative static and dynamic NRS scores, total tramadol consumption, side effects, and the need for additional analgesia were monitored and recorded at regular intervals. Primary outcome was NRS scores and secondary outcome was total tramadol consumption.

Block Techniques

All blocks were performed following surgical closure, prior to extubation, with the patient in lateral decubitus and the skin prepared with 10% povidone-iodine.

RIB:Rhomboid intercostal plane block procedure is performed using a high-frequency linear ultrasound probe. First, the rhomboid and intercostal muscles are located in the area called the auscultation triangle, at the level of thoracic 4-5 o'clock. A needle, visible on ultrasound, is advanced between the rhomboid and intercostal muscles using an in-plane technique. After aspiration is performed to ensure no blood or air is present, a total of 30 ml of 0.25% bupivacaine will be injected between the two muscle planes. The rhomboid intercostal plane block creates sensory paresthesia (sensory numbness) in a dermatomal region between T3 and T9 o'clock.

SPSIPB: The USG probe was placed 2-3 cm medial to the scapular spine to visualize the trapezius, rhomboid major, and serratus posterior superior muscles. At the level of the 2nd-3rd ribs, a needle was advanced into the plane between the serratus posterior superior muscle and the rib. After confirming negative aspiration, 30 mL of 0.25% bupivacaine was injected.

All blocks were performed unilaterally, targeting the surgical hemithorax.

Postoperative Analgesia and Assessments

Twenty minutes before extubation, all patients received 1 g IV paracetamol and 50 mg IV dexketoprofen. In the recovery room, patient-controlled analgesia (PCA) with IV tramadol hydrochloride was initiated (4 mg/mL concentration, 10 mg bolus, 20-minute lockout, maximum 3 boluses/hour).

Postoperative NRS scores (static at rest and dynamic during movement or coughing) were recorded at 0, 1, 2, 6, 12, 18, and 24 hours. The first NRS assessment (0 hour) was performed when the patient achieved an Aldrete score of 9. If NRS ≥ 4, an additional 50 mg IV tramadol was administered. Additional analgesic consumption was recorded. Side effects such as nausea, vomiting, and pruritus were documented.

Study Type

Study Type

Describes the nature of a clinical study. Study types include interventional studies (also called clinical trials), observational studies (including patient registries), and expanded access.
Interventional

Enrollment (Estimated)

Enrollment

The number of participants in a clinical study. The "anticipated" enrollment is the target number of participants that the researchers need for the study.
40

Phase

Phase

The stage of a clinical trial studying a drug or biological product, based on definitions developed by the U.S. Food and Drug Administration (FDA). The phase is based on the study's objective, the number of participants, and other characteristics. There are five phases: Early Phase 1 (formerly listed as Phase 0), Phase 1, Phase 2, Phase 3, and Phase 4. Not Applicable is used to describe trials without FDA-defined phases, including trials of devices or behavioral interventions.
  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Contact

The name and contact information for the person who can answer enrollment questions for a clinical study. Each location where the study is being conducted may also have a specific contact, who may be better able to answer those questions.

Study Contact Backup

Study Locations

  • Turkey (Türkiye)
    • Merkez
      • Sivas, Merkez, Turkey (Türkiye), 58000
        • Completed
        • Sivas Cumhuriyet University
    • Sivas
      • Sivas, Sivas, Turkey (Türkiye), 58140
        • Recruiting
        • Sivas Cumhuriyet University School of Medicine, Anesthesiology and Reanimation
        • Contact:

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Eligibility Criteria

The key requirements that people who want to participate in a clinical study must meet or the characteristics they must have. Eligibility criteria consist of both inclusion criteria (which are required for a person to participate in the study) and exclusion criteria (which prevent a person from participating). Types of eligibility criteria include whether a study accepts healthy volunteers, has age or age group requirements, or is limited by sex.

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  • Forty adult patients scheduled for elective wedge resection or biopsy under VATS, classified as American Society of Anesthesiologists (ASA) physical status I-III, were enrolled after providing written informed consent.

Exclusion Criteria:

  • ASA class IV or higher,
  • morbid obesity (BMI > 40 kg/m²),
  • body weight ≤ 50 kg,
  • skin infection at the block site,
  • refusal to participate,
  • inability to cooperate during postoperative pain assessment,
  • conversion to open surgery,
  • preexisting pain,
  • known allergy to any study medication,
  • coagulopathy.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Other
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Quadruple

Arms and Interventions

Participant Group / Arm

Participant Group / Arm

A group or subgroup of participants in a clinical trial that receives a specific intervention/treatment, or no intervention, according to the trial's protocol.
Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.
Active Comparator: SPSIP BLOCK
Arm Description: The USG probe was placed 2-3 cm medial to the scapular spine to visualize the trapezius, rhomboid major, and serratus posterior superior muscles. At the level of the 2nd-3rd ribs, a needle was advanced into the plane between the serratus posterior superior muscle and the rib. After confirming negative aspiration, 30 mL of 0.25% bupivacaine was injected. The block was performed unilaterally, targeting the surgical hemithorax.
Procedure: SPSIP block
The USG probe was placed 2-3 cm medial to the scapular spine to visualize the trapezius, rhomboid major, and serratus posterior superior muscles. At the level of the 2nd-3rd ribs, a needle was advanced into the plane between the serratus posterior superior muscle and the rib. After confirming negative aspiration, 30 mL of 0.25% bupivacaine was injected. The block was performed unilaterally, targeting the surgical hemithorax.
Active Comparator: RIB BLOCK
Arm Description:Rhomboid intercostal plane block procedure, 10% povidone-iodine will be used for skin cleansing. The procedure is performed using a high-frequency linear ultrasound probe. First, the rhomboid and intercostal muscles are located in the area called the auscultation triangle, at the level of thoracic 4-5 o'clock. A needle, visible on ultrasound, is advanced between the rhomboid and intercostal muscles using an in-plane technique. After aspiration is performed to ensure no blood or air is present, a total of 30 ml of 0.25% bupivacaine will be injected between the two muscle planes. The rhomboid intercostal plane block creates sensory paresthesia (sensory numbness) in a dermatomal region between T3 and T9 o'clock.
Procedure: RIB BLOCK
30 mL of 0.25% bupivacaine was injected deep to the rhomboid intercostal spinal block.

What is the study measuring?

Primary Outcome Measures

Primary Outcome Measures

In a clinical study's protocol, the planned outcome measure that is the most important for evaluating the effect of an intervention/treatment. Most clinical studies have one primary outcome measure, but some have more than one.
Outcome Measure
Measure Description
Time Frame
NUMERICAL RATING SCORE(NRS)
Time Frame: postoperative 24 hours
Numerical rating scale is used for pain assessment. The scores of the numerical rating scale changes between 0 to 10 points. 10 points mean "the most severe pain that the patient ever had". 0 point means "there is no pain." Higher scores mean worse outcome.
postoperative 24 hours

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Sponsor

The organization or person who initiates the study and who has authority and control over the study.
Cumhuriyet University

Investigators

Investigators

A researcher involved in a clinical study. Related terms include site principal investigator, site sub-investigator, study chair, study director, and study principal investigator.
  • Principal Investigator: OĞUZ GÜNDOĞDU, Sivas Cumhuriyet University School of Medicine, Anesthesiology and Reanimation

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

Study Start

The actual date on which the first participant was enrolled in a clinical study. The "anticipated" study start date is the date that the researchers think will be the study start date.
March 12, 2026

Primary Completion (Estimated)

Primary Completion

The date on which the last participant in a clinical study was examined or received an intervention to collect final data for the primary outcome measure. Whether the clinical study ended according to the protocol or was terminated does not affect this date. For clinical studies with more than one primary outcome measure with different completion dates, this term refers to the date on which data collection is completed for all the primary outcome measures. The "anticipated" primary completion date is the date that the researchers think will be the primary completion date for the study.
November 1, 2026

Study Completion (Estimated)

Study Completion

The date on which the last participant in a clinical study was examined or received an intervention/treatment to collect final data for the primary outcome measures, secondary outcome measures, and adverse events (that is, the last participant's last visit). The "anticipated" study completion date is the date that the researchers think will be the study completion date.
December 1, 2026

Study Registration Dates

First Submitted

First Submitted

The date on which the study sponsor or investigator first submitted a study record to ClinicalTrials.gov. There is typically a delay of a few days between the first submitted date and the record's availability on ClinicalTrials.gov (the first posted date).
April 6, 2026

First Submitted That Met QC Criteria

First Submitted That Met QC Criteria

The date on which the study sponsor or investigator first submits a study record that is consistent with National Library of Medicine (NLM) quality control (QC) review criteria. The sponsor or investigator may need to revise and submit a study record one or more times before NLM's QC review criteria are met. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
April 6, 2026

First Posted (Actual)

First Posted

The date on which the study record was first available on ClinicalTrials.gov after National Library of Medicine (NLM) quality control (QC) review has concluded. There is typically a delay of a few days between the date the study sponsor or investigator submitted the study record and the first posted date.
April 13, 2026

Study Record Updates

Last Update Posted (Actual)

Last Update Posted

The most recent date on which changes to a study record were made available on ClinicalTrials.gov. There may be a delay between when the changes were submitted to ClinicalTrials.gov by the study's sponsor or investigator (the last update submitted date) and the last update posted date.
June 3, 2026

Last Update Submitted That Met QC Criteria

Last Update Submitted That Met QC Criteria

The most recent date on which the study sponsor or investigator submitted changes to a study record that are consistent with National Library of Medicine (NLM) quality control (QC) review criteria. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
June 2, 2026

Last Verified

Last Verified

The most recent date on which the study sponsor or investigator confirmed the information about a clinical study on ClinicalTrials.gov as accurate and current. If a study with a recruitment status of recruiting; not yet recruiting; or active, not recruiting has not been confirmed within the past 2 years, the study's recruitment status is shown as unknown.
June 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

Other Study ID Numbers

Identifiers or ID numbers other than the NCT number that are assigned to a clinical study by the study's sponsor, funders, or others. These numbers may include unique identifiers from other trial registries and National Institutes of Health grant numbers.
  • 2026-04/01

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

Clinical Trials on Postoperative Pain Management

Clinical Trials on SPSIP block

Search Similar Trials

Sponsors and Collaborators

Medical Conditions

Drug Interventions

Conditions

Rare Diseases

Drug Interventions

Dietary Supplements

Sponsor/Collaborators

Locations

Cookie Settings

We use cookies to ensure that we give you the best experience on our website. For more details carefully read our Privacy and Cookies Policy. ...>>>You can change your preferences or withdraw your consent at any time by deleting the cookies from your website or computer as described in the policy. Please accept it and choose your preferences by ticking the corresponding boxes in the "Manage Settings" section below. Please carefully read our Terms of Service before you proceed with using any part of this website.
«Manage Settings