Analgesic Efficiency of SIPSPB vs ICNB in VATS Surgery

May 18, 2026 updated by: Abdullah Bozkurt, Kocaeli City Hospital

Comparison Of The Analgesic Effectiveness Of Ultrasonography-Guided Serratus Posterıor Superior Intercostal Plane (SPSIP) Block And Intercostal Nerve (ICN) Block In Video-Assisted Thoracoscopic Surgery Patients

This study aims to evaluate the effectiveness of Serratus Posterior Superior Intercostal Plane (SPSIP) block compared to Intercostal Nerve (ICN) block in terms of postoperative pain control, reduction of opioid analgesic consumption, minimization of postoperative respiratory complications, and increase patient satisfaction (using a 5-point Likert scale) in patients undergoing video-assisted thoracoscopic surgery (VATS).

Study Overview

Status

Recruiting

Conditions

Detailed Description

In this prospective observational study, patients included in the study will receive Serratus Posterior Superior Intercostal Plane (SPSIP) block and Intercostal Nerve (ICN) block for postoperative analgesia at the end of surgery. The SPSIP block will be performed by the anesthesiologist under ultrasound guidance immediately after skin closure and before extubation, while the ICN block will be performed by the surgeon under direct vision immediately before skin closure.

At the end of surgery, patients will receive 1000 mg paracetamol and 50 mg dexketoprofen during skin closure. Upon arrival at the recovery room, each patient will be connected to a patient-controlled analgesia (PCA) pump containing tramadol. At postoperative reassessment, patients with a Numerical Pain Rating Scale (NPRS) score greater than 4 despite PCA use will receive a rescue analgesic dose of 50 mg dexketoprofen.

Postoperative pain intensity will be assessed using the NPRS (Numerical Pain Rating Scale) at 1, 4, 6, 12, 18, and 24 hours postoperatively, both at rest and during coughing. Total opioid consumption, rescue analgesic use, and postoperative complications will be recorded.

Patients will be informed about their level of surgical satisfaction 24 hours after surgery, and this information will be recorded.

Study Type

Observational

Enrollment (Estimated)

80

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 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

Sampling Method

Probability Sample

Study Population

Patients who will undergo elective VATS surgery in the thoracic surgery operating room of Kocaeli City Hospital

Description

Inclusion Criteria:

  • Aged 18-80 years,
  • American Society of Anesthesiologists (ASA) physical status I-III
  • Patients who have provided informed consent to participate in the study

Exclusion Criteria:

  • Patients who refuse to participate in the study by not signing the informed consent
  • Patients classified as ASA > 3, according to the system established by the American Society of Anesthesiologists
  • Patients unable to understand the use of the NPR Scale or the PCA device that will be used for postoperative analgesia
  • Coagulation disorders or anticoagulant therapy contraindicating regional anesthesia
  • Patients with allergies to analgesic and/or anesthetic drugs
  • Infection at the block injection site
  • Patients whose surgical procedure is intraoperatively converted to an open pulmonary resection

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

Cohorts and Interventions

Group / Cohort
Group SPSIP Block
In patients meeting the inclusion criteria for the study, an ultrasound-guided interfacial plane block is applied between the posterior superior serratus muscle and the underlying ribs in patients undergoing SPSIP block after VATS.
Group ICN Block
Patients meeting the inclusion criteria for the study who will undergo intercostal nerve block after VATS will have a total of 10 ml of 0.5% bupivacaine applied to two segments (upper and lower segments of the incision line) under direct vision by the surgeon while the patient is in the lateral decubitus position at the end of the operation and immediately before skin closure.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Postoperative pain intensity
Time Frame: 24 hours after the end of surgery
In both study groups, postoperative pain intensity at rest and with coughing was measured using the Numerical Pain Rating Scale (NPRS), a numerical scale ranging from 0 to 10 (0 meaning no pain, 10 meaning the most severe pain imaginable).
24 hours after the end of surgery

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Patient satisfaction score
Time Frame: At the 24th hour post-operation
evaluated using a 5-point Likert scale (1=very dissatisfied, 5=very satisfied)
At the 24th hour post-operation
Total opioid drug consumption
Time Frame: 24 hours after the end of surgery
The total amount of opioid doses administered via a Patient Controlled Analgesia (PCA) device in the first 24 hours after surgery
24 hours after the end of surgery
Consumption of rescue analgesics
Time Frame: 24 hours after the end of surgery
The total dose of dexketoprofen required by the patient during each specified time interval in the first 24 hours after surgery.
24 hours after the end of surgery
Postoperative Complications
Time Frame: 24 hours after the end of surgery
Postoperative complications such as nausea, vomiting or other adverse events will be recorded
24 hours after the end of surgery

Collaborators and Investigators

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

Sponsor

Kocaeli City Hospital

Investigators

  • Study Director: Ayşe Z Turan Cıvraz, Assoc. Prof., Kocaeli City Hospital

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

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)

May 18, 2026

Primary Completion (Estimated)

August 1, 2026

Study Completion (Estimated)

August 1, 2026

Study Registration Dates

First Submitted

May 5, 2026

First Submitted That Met QC Criteria

May 5, 2026

First Posted (Actual)

May 11, 2026

Study Record Updates

Last Update Posted (Actual)

May 20, 2026

Last Update Submitted That Met QC Criteria

May 18, 2026

Last Verified

May 1, 2026

More Information

Terms related to this study

Keywords

Other Study ID Numbers

  • 250125

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.

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