Serratus Posterior Superior Intercostal Plane Block

January 4, 2026 updated by: Elzem SEN, University of Gaziantep

Evaluation of the Efficacy of Ultrasound-Guided Serratus Posterior Superior Intercostal Plane Block For Postoperative Analgesia in Thoracic Surgery

Background: Adequate pain control after video-assisted thoracoscopic surgery (VATS) remains a major clinical challenge. Traditional techniques such as thoracic epidural analgesia are effective but limited by potential complications. Interfascial plane blocks have recently gained interest as safer alternatives. The serratus posterior superior intercostal plane block (SPSIPB) is a novel regional anesthesia technique with potential benefits in thoracic surgery.

Objective: The purpose of this study was to evaluate the analgesic efficacy of ultrasound-guided SPSIPB compared with subcutaneous morphine administration in patients undergoing VATS.

Methods: In this prospective, randomized controlled trial, 60 patients scheduled for elective VATS were randomized into two groups: SPSIPB group (n=30) and control group receiving subcutaneous morphine (n=30). The primary outcome was postoperative pain intensity measured by the visual analog scale (VAS) at rest and during coughing. Secondary outcomes included opioid consumption, number of patient-controlled analgesia (PCA) demands, rescue analgesia requirements, and incidence of adverse effects.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

Background and Rationale:

Effective postoperative analgesia after thoracic surgery is essential to prevent pulmonary complications, enhance recovery, and improve patient satisfaction. Although thoracic epidural analgesia has traditionally been considered the gold standard, its use is limited due to potential complications such as hypotension, urinary retention, and technical difficulties. With the increased use of minimally invasive thoracic procedures, including video-assisted thoracoscopic surgery (VATS), safer and less invasive analgesic techniques are being explored.

The serratus posterior superior intercostal plane block (SPSIPB) is a newly described regional anesthesia technique that targets the posterior thoracic intercostal nerves. Preliminary evidence suggests that SPSIPB may provide effective postoperative analgesia while minimizing procedure-related risks.

Objective:

The aim of this study was to evaluate the analgesic efficacy and safety of ultrasound-guided SPSIPB compared with subcutaneous morphine injection for postoperative pain management in patients undergoing VATS.

Study Design:

This was a prospective, randomized controlled, single-center clinical trial conducted at Gaziantep University Faculty of Medicine, Department of Anesthesiology. Sixty patients scheduled for elective VATS under general anesthesia were enrolled. After obtaining informed consent, patients were randomly allocated into two groups:

SPSIPB Group (n = 30): Patients received an ultrasound-guided serratus posterior superior intercostal plane block with 20 mL of local anesthetic at the end of surgery.

Control Group (n = 30): Patients received subcutaneous morphine injection according to institutional standard practice.

Outcome Measures:

The primary outcome was postoperative pain intensity assessed by the Visual Analog Scale (VAS) at rest and during coughing at multiple time points within the first 24 hours after surgery. Secondary outcomes included total opioid consumption within 24 hours, the number of patient-controlled analgesia (PCA) demands, the need for rescue analgesia, and the incidence of adverse events such as nausea, vomiting, respiratory depression, or block-related complications.

Significance:

This study will contribute to the growing evidence on interfascial plane blocks in thoracic surgery. If proven effective, SPSIPB may serve as a safe and valuable alternative to conventional analgesic methods, reducing opioid consumption and related side effects in patients undergoing VATS.

Study Type

Interventional

Enrollment (Actual)

60

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

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

Inclusion Criteria:

  1. Age between 18 and 70 years
  2. American Society of Anesthesiologists (ASA) physical status I-III
  3. Scheduled for elective video-assisted thoracoscopic surgery (VATS) under general anesthesia
  4. Provision of written informed consent

Exclusion Criteria:

  1. Conversion to thoracotomy during surgery
  2. Coagulopathy or ongoing anticoagulant therapy
  3. Local infection at the injection site
  4. Known allergy to local anesthetics or morphine
  5. Severe cardiopulmonary disease contraindicating regional anesthesia
  6. Refusal to participate in the study

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: Single

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: SPSIPB Group
Patients received an ultrasound-guided SPSIPB with 20 mL local anesthetic at the end of surgery.
Procedure: Ultrasound-guided Serratus Posterior Superior Intercostal Plane Block
Intervention Type: Procedure (Regional Anesthesia) Name: Ultrasound-guided Serratus Posterior Superior Intercostal Plane Block (SPSIPB) Description: A single injection of 20 mL of local anesthetic was administered under ultrasound guidance into the serratus posterior superior intercostal plane at the end of surgery.
Active Comparator: Active Comparator
Patients received a subcutaneous morphine injection according to institutional standard practice after surgery.
Drug: Subcutaneous Morphine
Intervention Type: Drug (Morphine) Name: Subcutaneous Morphine Description: Patients received a single subcutaneous injection of morphine (dose according to institutional standard practice) after surgery.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Postoperative Pain Intensity
Time Frame: 24 hours after surgery (measured at 0, 2, 4, 8, 16, and 24 hours)
Pain intensity was assessed using the Visual Analog Scale (VAS; 0 = no pain, 10 = worst pain imaginable) at rest and during coughing.
24 hours after surgery (measured at 0, 2, 4, 8, 16, and 24 hours)

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Total opioid consumption within 24 hours
Time Frame: 24 hours after surgery (cumulative from 0 to 24 hours)
The cumulative opioid dose administered via patient-controlled analgesia (PCA) and rescue doses was recorded.
24 hours after surgery (cumulative from 0 to 24 hours)

Collaborators and Investigators

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

Sponsor

University of Gaziantep

Investigators

  • Principal Investigator: Elzem Şen, Assoc. Prof, University of Gaziantep

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)

February 2, 2024

Primary Completion (Actual)

August 1, 2024

Study Completion (Actual)

August 1, 2024

Study Registration Dates

First Submitted

December 9, 2025

First Submitted That Met QC Criteria

January 4, 2026

First Posted (Actual)

January 9, 2026

Study Record Updates

Last Update Posted (Actual)

January 9, 2026

Last Update Submitted That Met QC Criteria

January 4, 2026

Last Verified

January 1, 2026

More Information

Terms related to this study

Additional Relevant MeSH Terms

Other Study ID Numbers

  • 2023/376

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, Acute

Clinical Trials on Ultrasound-guided Serratus Posterior Superior Intercostal Plane Block

Search Similar Trials

Sponsors and Collaborators

Medical Conditions

Drug Interventions

CROs by country

CROs in Mongolia

Conditions

Rare Diseases

Drug Interventions

Dietary Supplements

Sponsor/Collaborators

Locations

Subscribe