Serratus Posterior Superior Intercostal Plane Block in Minimally Invasive Cardiac Surgery

May 16, 2026 updated by: Fatma Acil,MD, Saglik Bilimleri Universitesi Gazi Yasargil Training and Research Hospital

Preoperative Serratus Posterior Superior Intercostal Plane Block for Analgesia and Opioid Sparing in Patients Undergoing Minimally Invasive Cardiac Valve Surgery Via Mini-Thoracotomy: A Randomized, Double-Blind, Placebo-Controlled Trial

This randomized, double-blind, placebo-controlled study aims to evaluate the effect of the serratus posterior superior intercostal plane (SPSIP) block on postoperative pain and opioid consumption in patients undergoing minimally invasive cardiac valve surgery via mini-thoracotomy.

Study Overview

Status

Recruiting

Conditions

Intervention / Treatment

Detailed Description

This study is a prospective, randomized, double-blind, placebo-controlled clinical trial designed to evaluate the analgesic efficacy of the serratus posterior superior intercostal plane (SPSIP) block in patients undergoing minimally invasive cardiac valve surgery via mini-thoracotomy. Postoperative pain following thoracic cardiac surgery may impair respiratory function and delay recovery, making effective analgesia essential.

Participants will be randomly assigned to receive an ultrasound-guided SPSIP block with either bupivacaine or normal saline under identical conditions. All patients will receive standardized general anesthesia and postoperative multimodal analgesia. Blinding will be ensured for patients and outcome assessors.

The study aims to determine whether SPSIP block with local anesthetic reduces postoperative opioid consumption and improves pain control compared to placebo.

Study Type

Interventional

Enrollment (Estimated)

90

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 Contact

Study Locations

  • Turkey (Türkiye)
    • Outside of the US
      • Diyarbakır, Outside of the US, Turkey (Türkiye), 21070
        • Recruiting
        • Fatma Acil
        • 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

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  • Adult patients aged 18-75 years
  • ASA physical status I-III
  • Scheduled for elective minimally invasive cardiac valve surgery via mini-thoracotomy
  • Able to understand and use the Numeric Rating Scale (NRS)
  • Provided written informed consent

Exclusion Criteria:

  • Age >75 years
  • Known allergy or hypersensitivity to local anesthetics (e.g., bupivacaine)
  • Coagulopathy or ongoing anticoagulant therapy that cannot be discontinued
  • Infection at the planned block site
  • Chronic opioid use or chronic pain conditions
  • Severe pulmonary disease affecting respiratory assessment
  • Neurological or psychiatric disorders interfering with pain assessment
  • Emergency surgery
  • Pregnancy or breastfeeding
  • Refusal to participate

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: Quadruple

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Serratus Posterior Superior Intercostal Plane Block with Bupivacaine
Participants will receive an ultrasound-guided serratus posterior superior intercostal plane (SPSIP) block with bupivacaine prior to surgery, in addition to standard general anesthesia and multimodal analgesia.
Procedure: Serratus Posterior Superior Intercostal Plane Block With Bupivacaine
Participants in this group will receive an ultrasound-guided serratus posterior superior intercostal plane (SPSIP) block prior to surgery using 30 mL of 0.25% bupivacaine, in addition to standard general anesthesia and multimodal analgesia.
Other Names:
  • SPSIP Block
Placebo Comparator: Serratus Posterior Superior Intercostal Plane Block with Saline
Participants will receive an ultrasound-guided serratus posterior superior intercostal plane (SPSIP) block with normal saline under identical conditions, in addition to standard general anesthesia and multimodal analgesia.
Procedure: Serratus Posterior Superior Intercostal Plane Block With Saline
Participants in this group will receive an ultrasound-guided placebo block using 30 mL of normal saline under identical conditions, in addition to standard general anesthesia and multimodal analgesia.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
24-hour cumulative opioid consumption
Time Frame: 24 hours after surgery
Total opioid consumption within the first 24 hours after surgery, expressed as intravenous morphine milligram equivalents (IV-MME).
24 hours after surgery

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Time to first rescue analgesia
Time Frame: Within 24 hours after surgery
Time from the end of surgery to the first administration of rescue analgesia.
Within 24 hours after surgery
Postoperative pain intensity at rest (NRS)
Time Frame: 4, 6, 12, and 24 hours after surgery
Pain intensity at rest measured using the Numeric Rating Scale (0-10).
4, 6, 12, and 24 hours after surgery
Postoperative pain during movement (NRS)
Time Frame: 4, 6, 12, and 24 hours after surgery
Pain intensity during coughing or deep breathing measured using the Numeric Rating Scale (0-10).
4, 6, 12, and 24 hours after surgery
Time to extubation
Time Frame: From the end of surgery until extubation, assessed up to 24 hours
Time from the end of surgery to extubation.
From the end of surgery until extubation, assessed up to 24 hours
Length of intensive care unit stay
Time Frame: Through study completion, an average of 48 hours
Duration of stay in the intensive care unit.
Through study completion, an average of 48 hours
Length of hospital stay
Time Frame: From date of admission until discharge, up to 30 days
Total duration of hospitalization.
From date of admission until discharge, up to 30 days
Inspiratory Spirometry Test
Time Frame: 4, 6, 12, and 24 hours after surgery
Inspiratory spirometry performance will be assessed using an incentive spirometer. Inspiratory capacity will be estimated based on the number of rising balls: 1 ball = 600 mL, 2 balls = 900 mL, and 3 balls = 1200 mL. The score ranges from a minimum of 1 ball to a maximum of 3 balls, with higher scores indicating better inspiratory function.
4, 6, 12, and 24 hours after surgery

Collaborators and Investigators

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

Sponsor

Saglik Bilimleri Universitesi Gazi Yasargil Training and Research Hospital

Investigators

  • Principal Investigator: Fatma Acil, M.D., Saglik Bilimleri Universitesi Gazi Yasargil Training and Research Hospital

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 16, 2026

Primary Completion (Estimated)

October 25, 2026

Study Completion (Estimated)

October 26, 2026

Study Registration Dates

First Submitted

May 5, 2026

First Submitted That Met QC Criteria

May 11, 2026

First Posted (Actual)

May 14, 2026

Study Record Updates

Last Update Posted (Actual)

May 19, 2026

Last Update Submitted That Met QC Criteria

May 16, 2026

Last Verified

May 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • 07/04/2026-132

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

YES

IPD Plan Description

De-identified individual participant data that underlie the results reported in this article (text, tables, figures, and appendices) will be shared.

IPD Sharing Time Frame

Starting 6 months and ending 36 months following article publication.

IPD Sharing Access Criteria

Data will be available to researchers who provide a methodologically sound proposal. Proposals should be directed to acilfatma@gmail.com

IPD Sharing Supporting Information Type

  • STUDY_PROTOCOL
  • ICF

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

Clinical Trials on Serratus Posterior Superior Intercostal Plane Block With Bupivacaine

Search Similar Trials

Sponsors and Collaborators

Medical Conditions

Drug Interventions

CROs by country

CROs in Turkmenistan

Conditions

Rare Diseases

Drug Interventions

Dietary Supplements

Sponsor/Collaborators

Locations

Subscribe