Effect of Different Local Anesthetic Volumes of Serratus Anterior Plan Block After Video-Assisted Thoracoscopic Surgery

The Effect of Different Local Anesthetic Volumes of Serratus Anterior Plan Block Performed With Ultrasound on Acute Pain After Video-Assisted Thoracoscopic Surgery

Video-assisted thoracic surgery (VATS) has become a common procedure in thoracic surgery. Severe postoperative pain may be encountered in patients undergoing VATS. Analgesic methods such as thoracic paravertebral block (TPVB), intercostal block, serratus anterior plane block (SAPB), and erector spinae plane block (ESPB) are widely used for VATS. Among these methods, ultrasound (US) guided TPVB is the most preferred method. In recent years, the frequency of application of plane blocks as a component of multimodal analgesia has been increased. ESPB and SAPB are some of them. In addition, SAPB application is increasing in patients who underwent thoracotomy and VATS. There is no consensus on the dose of analgesia in these studies. There are studies on volumes between 10 ml and 40 ml in the literature. In this study, it was aimed to compare the volumes of 20 ml and 30 ml containing local anesthetic at the same concentration (0.25% bupivacaine) of SAPB block to be performed with USG in patients who underwent VATS.

Study Overview

• Status: Recruiting
• Conditions: Pain, Postoperative; Serratus Anterior Plane Block; Thoracic Surgery, Video-Assisted; Local Anesthetic
• Intervention / Treatment: Procedure: Serratus Anterior Plan Block with 20 ml; Procedure: Serratus Anterior Plan Block with 30 ml

• Study Type: Interventional
• Enrollment (Estimated): 60
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Musa Zengin, MD; Phone Number: 903125677233; Email: musazengin@gmail.com
• Study Contact Backup: Name: Ali Alagoz, Assoc Prof; Phone Number: +903125677232; Email: mdalagoz@gmail.com

Study Locations

• Turkey
  • Ankara
    • Kecioren, Ankara, Turkey, 06000
      • Recruiting
      • Ankara Atatürk Chest Disease and Chest Surgery Training and Research Hospital
      • Contact: Musa Zengin, MD; Phone Number: +903125677233; Email: musazengin@gmail.com

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years to 65 years (Adult, Older Adult)
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• 18 to 65 years old
• ASA physical status I-II-III
• BMI 18 to 30 kg/m2
• Elective video assisted thoracoscopic surgery

Exclusion Criteria:

• Patient refusing the procedure
• Emergency surgery
• Chronic opioid or analgesic use

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Double

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Active Comparator: Serratus Anterior Plan Block with 20 ml %0.25 Bupivacaine; Following the visualization of the anatomical structures, the nerve block needle will be advanced via the in-plane technique above the serratus anterior muscles until the interfascial space was reached. After hydrodissection with 2 ml normal saline, 20 ml 0.25% bupivacaine will be injected into the area.	Procedure: Serratus Anterior Plan Block with 20 ml; Superficial serratus anterior plane block with 20 ml will be applied to the patients under real-time ultrasound guidance.; Other Names: Drug
Active Comparator: Serratus Anterior Plan Block with 30 ml %0.25 Bupivacaine; Following the visualization of the anatomical structures, the nerve block needle will be advanced via the in-plane technique above the serratus anterior muscles until the interfascial space was reached. After hydrodissection with 2 ml normal saline, 30 ml 0.25% bupivacaine will be injected into the area.	Procedure: Serratus Anterior Plan Block with 30 ml; Superficial serratus anterior plane block with 30 ml will be applied to the patients under real-time ultrasound guidance.; Other Names: Drug

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Pain Scores	Pain will be assessed at rest and while coughing using the visual analog scale on a scale from 0 (no pain) to 10 (worst pain). Pain assessment will be done at 1st, 2nd, 4th, 8th, 16th, 24th and 48th hours after surgery.	48 hours after surgery

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Morphine Consumption	Morphine consumption for 24 hours will be recorded	24 hours after surgery

Collaborators and Investigators

• Sponsor: Atatürk Chest Diseases and Chest Surgery Training and Research Hospital
• Investigators: Principal Investigator: Musa Zengin, MD, Atatürk Chest Diseases and Chest Surgery Training and Research Hospital

Study record dates

Study Major Dates

• Study Start (Actual): February 15, 2022
• Primary Completion (Estimated): April 15, 2024
• Study Completion (Estimated): May 15, 2024

Study Registration Dates

• First Submitted: February 15, 2022
• First Submitted That Met QC Criteria: February 15, 2022
• First Posted (Actual): February 24, 2022

Study Record Updates

• Last Update Posted (Actual): February 2, 2024
• Last Update Submitted That Met QC Criteria: February 1, 2024
• Last Verified: February 1, 2024

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Pathologic Processes; Postoperative Complications; Pain; Neurologic Manifestations; Pain, Postoperative
• Other Study ID Numbers: E.Kurul-E1-22-2371

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No