Serratus Anterior Plan Block (SAP) and Pectoralis Blocks (PECS I-II) After Open Heart Surgery

May 13, 2026 updated by: Arzu Esen Tekeli, Yuzuncu Yil University

Serratus Anterior Plane and PECS II Blocks for Postoperative Analgesia After CABG: a Randomized Controlled Trial

It was aimed to examine the effects of anterior chest wall blocks (PECS and SAP) performed for postoperative analgesia on pain scores assessed using the Visual Analog Scale (VAS), opioid consumption, duration of mechanical ventilation, time to first mobilization, ICU length of stay, postoperative nausea and vomiting (PONV), and block-related complications in adult patients undergoing coronary artery bypass grafting (CABG).

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

This prospective randomized controlled trial evaluated the postoperative analgesic efficacy of ultrasound-guided serratus anterior plane (SAP) block and PECS II block in adult patients undergoing elective coronary artery bypass grafting (CABG). Eligible patients were randomized into three groups: SAP block, PECS II block, and a control group receiving standard systemic analgesia without regional block. The primary outcome was postoperative pain intensity assessed by Visual Analog Scale (VAS) scores at predefined post-extubation time points. Secondary outcomes included total opioid consumption within the first 24 postoperative hours, postoperative nausea and vomiting (PONV), and block-related complications. Exploratory recovery-related outcomes included mechanical ventilation duration, time to first mobilization, and ICU length of stay. Recovery-related outcomes were analyzed descriptively and considered exploratory because ICU clinicians were not blinded and important perioperative confounders were not systematically collected.

Study Type

Interventional

Enrollment (Actual)

243

Phase

  • 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 Locations

  • Turkey (Türkiye)
    • Tuşba
      • Van, Tuşba, Turkey (Türkiye), 65080
        • Van Yuzuncu Yil University Faculty of Medicine Department of anesthesiology and reanimation

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

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Description

  • Adult patients aged 20 years and older
  • ASA physical status II-IV
  • Scheduled for elective coronary artery bypass grafting (CABG)
  • Provided written informed consent

Exclusion Criteria:

  • Refusal to participate
  • Pregnancy
  • Presence of bleeding diathesis
  • Severe hepatic or renal failure

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: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Single

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: SAP Block Group
Patients undergoing coronary artery bypass grafting received an ultrasound-guided serratus anterior plane (SAP) block with 30 mL of 0.25% bupivacaine administered to the fascial plane.
Procedure: Serratus Anterior Plane Block
Ultrasound-guided serratus anterior plane (SAP) block performed with 30 mL of 0.25% bupivacaine.
Active Comparator: PECS II Block Group
Patients undergoing coronary artery bypass grafting received an ultrasound-guided PECS II block using a two-injection technique with a total of 30 mL of 0.25% bupivacaine.
Procedure: PECS II Block
Ultrasound-guided PECS II block performed using a two-injection technique with a total of 30 mL of 0.25% bupivacaine.
No Intervention: Group C
Patients receiving standard systemic analgesia without regional block. All patients received intravenous paracetamol and rescue opioid analgesia as required according to institutional protocol.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Postoperative pain intensity assessed using the Visual Analog Scale (VAS)
Time Frame: 4, 8, 12, and 24 hours after extubation
Pain intensity will be assessed using the Visual Analog Scale (VAS). The VAS is a 10-centimeter scale where 0 cm = "no pain" and 10 cm = "worst imaginable pain"; higher scores indicate worse pain intensity. Assessments will be performed at 4, 8, 12, and 24 hours after extubation.
4, 8, 12, and 24 hours after extubation

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Postoperative nausea and vomiting (PONV) and block-related complications
Time Frame: Within 24 hours after surgery
Postoperative adverse events including nausea, vomiting, and block-related complications will be recorded.
Within 24 hours after surgery
Exploratory ICU length of stay
Time Frame: From ICU admission until ICU discharge, assessed up to 30 days
Length of stay in the intensive care unit measured in hours from ICU admission
From ICU admission until ICU discharge, assessed up to 30 days
Exploratory time to first mobilization
Time Frame: From ICU admission until first mobilization, assessed up to 7 days
Time from ICU admission to first mobilization measured in hours
From ICU admission until first mobilization, assessed up to 7 days
Exploratory mechanical ventilation duration
Time Frame: From ICU admission until successful extubation, assessed up to 7 days
Time from ICU admission to successful extubation
From ICU admission until successful extubation, assessed up to 7 days
Total opioid consumption within the first 24 postoperative hours
Time Frame: Cumulative opioid consumption assessed during the first 24 postoperative hours
Total postoperative opioid consumption will be recorded as cumulative tramadol and pethidine doses administered within the first 24 postoperative hours and converted to intravenous morphine equivalents.
Cumulative opioid consumption assessed during the first 24 postoperative hours

Collaborators and Investigators

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

Sponsor

Yuzuncu Yil University

Investigators

  • Study Chair: School of Mdicine Department of Anesthesiology and Reanimation, Yuzuncu Yil University

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)

December 5, 2022

Primary Completion (Actual)

December 5, 2023

Study Completion (Actual)

January 31, 2024

Study Registration Dates

First Submitted

May 17, 2023

First Submitted That Met QC Criteria

January 20, 2025

First Posted (Actual)

January 27, 2025

Study Record Updates

Last Update Posted (Actual)

May 18, 2026

Last Update Submitted That Met QC Criteria

May 13, 2026

Last Verified

May 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • 17/05/2023

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

IPD Plan Description

Participants' personal information will not be shared.

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.

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