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SPSIP Versus RISS Block in Volume-Preserving VATS (SRVATS)

12. juni 2026 opdateret af: Ferit Yetik

Comparison of Serratus Posterior Superior Intercostal Plane Block and Rhomboid Intercostal-Subserratus Plane Block on Postoperative Analgesia and Respiratory Functions in Volume-Preserving Video-Assisted Thoracoscopic Surgery: A Prospective Randomized Controlled Trial

This prospective randomized controlled study aims to compare the effects of Serratus Posterior Superior Intercostal Plane (SPSIP) block and Rhomboid Intercostal and Subserratus (RISS) block on postoperative pain, respiratory function, and recovery quality in patients undergoing volume-preserving video-assisted thoracoscopic surgery (VATS). Eighty-four patients will be randomized in a 1:1 ratio to receive either SPSIP block or RISS block. The primary outcome is the incidence of somatic pain at the chest drain insertion site at postoperative 2 hours. Secondary outcomes include pain scores, opioid consumption, quality of recovery, diaphragmatic function, pulmonary function, rescue analgesic requirements, postoperative nausea and vomiting, and block-related complications.

Studieoversigt

Status

Ikke rekrutterer endnu

Betingelser

Intervention / Behandling

Detaljeret beskrivelse

Video-assisted thoracoscopic surgery (VATS) is associated with significant postoperative pain that may impair respiratory function and delay recovery. Regional anesthesia techniques are increasingly used to improve analgesia while minimizing opioid-related adverse effects.

The Serratus Posterior Superior Intercostal Plane (SPSIP) block and the Rhomboid Intercostal and Subserratus (RISS) block are novel ultrasound-guided fascial plane blocks that provide thoracic analgesia through different mechanisms. However, comparative clinical evidence regarding their efficacy in VATS patients remains limited.

This prospective, randomized, controlled study will enroll 84 adult patients scheduled for volume-preserving VATS. Participants will be randomly assigned to receive either SPSIP block or RISS block in a 1:1 ratio (42 patients per group).

The primary endpoint is the incidence of somatic pain at the chest drain insertion site at postoperative 2 hours.

Secondary endpoints include postoperative pain scores at rest and during movement, total intravenous morphine consumption during the first 24 postoperative hours, Quality of Recovery-15 (QoR-15) score at postoperative 24 hours, diaphragmatic excursion measured by ultrasonography, peak expiratory flow measurements, rescue analgesic requirements, time to first rescue analgesia, incidence of postoperative nausea and vomiting, and block-related complications.

The study has been approved by the Bursa Sehir Hospital Clinical Research Ethics Committee and will be conducted in accordance with the Declaration of Helsinki and Good Clinical Practice principles.

Undersøgelsestype

Interventionel

Tilmelding (Anslået)

84

Fase

  • Ikke anvendelig

Kontakter og lokationer

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Studiekontakt

Studiesteder

  • Tyrkiet (Türkiye)
    • Nilüfer
      • Bursa, Nilüfer, Tyrkiet (Türkiye), 16100
        • Bursa City Hospital
        • Kontakt:
        • Ledende efterforsker:
          • Yusuf Alan, MD
        • Underforsker:
          • Onur Gunes, MD
        • Underforsker:
          • Halil ERTEK, MD

Deltagelseskriterier

Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.

Berettigelseskriterier

Aldre berettiget til at studere

  • Voksen
  • Ældre voksen

Tager imod sunde frivillige

Ingen

Beskrivelse

Inclusion Criteria:

  • Patients scheduled for elective biportal video-assisted thoracoscopic surgery (VATS) with lung parenchyma-preserving thoracic procedures under general anesthesia
  • American Society of Anesthesiologists (ASA) physical status I-III
  • Age between 18 and 75 years
  • Provision of written informed consent

Exclusion Criteria:

  • Use of anticoagulant or antiplatelet therapy
  • Bleeding diathesis
  • Known allergy to local anesthetics
  • Infection at the planned block site
  • Severe chronic pulmonary disease or advanced respiratory failure (e.g., severe COPD or restrictive lung disease)
  • Cognitive impairment preventing reliable NRS assessment
  • Pregnancy or lactation
  • Chronic opioid use (regular use for ≥3 months)
  • Severe hepatic or renal failure
  • Refusal to participate
  • Technical failure or unsuccessful regional block
  • Conversion to open thoracotomy during surgery

Studieplan

Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

  • Primært formål: Behandling
  • Tildeling: Randomiseret
  • Interventionel model: Parallel tildeling
  • Maskning: Firedobbelt

Våben og indgreb

Deltagergruppe / Arm
Intervention / Behandling
Eksperimentel: SPSIP Block Group
Patients will receive an ultrasound-guided Serratus Posterior Superior Intercostal Plane (SPSIP) block before induction of general anesthesia for postoperative analgesia after video-assisted thoracic surgery (VATS).
Procedure: Serratus posterior superior intercostal plane block
Ultrasound-guided Serratus Posterior Superior Intercostal Plane (SPSIP) block performed before induction of general anesthesia using local anesthetic for postoperative analgesia in patients undergoing video-assisted thoracic surgery.
Eksperimentel: RISS Block Group
Patients will receive an ultrasound-guided Rhomboid Intercostal and Subserratus (RISS) block before induction of general anesthesia for postoperative analgesia after video-assisted thoracic surgery (VATS).
Procedure: Rhomboid Intercostal and Subserratus Block
Ultrasound-guided Rhomboid Intercostal and Subserratus (RISS) block performed before induction of general anesthesia using local anesthetic for postoperative analgesia in patients undergoing video-assisted thoracic surgery.

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Incidence of Somatic Pain at Chest Tube Insertion Site
Tidsramme: Postoperative 2 hours
Incidence of somatic pain localized at the chest tube insertion site, defined as sharp localized pain aggravated by coughing or deep inspiration, recorded as present or absent.
Postoperative 2 hours

Sekundære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Postoperative Pain Scores at Rest
Tidsramme: Postoperative 2, 6, 12, and 24 hours
Static postoperative pain scores assessed using the Numeric Rating Scale (NRS) at rest.
Postoperative 2, 6, 12, and 24 hours
Postoperative Pain Scores During Movement
Tidsramme: Postoperative 2, 6, 12, and 24 hours
Dynamic postoperative pain scores assessed using the Numeric Rating Scale (NRS) during movement.
Postoperative 2, 6, 12, and 24 hours
Total Intravenous Morphine Consumption
Tidsramme: Postoperative 24 hours
Total intravenous morphine consumption during the first 24 hours after surgery.
Postoperative 24 hours
Interval Intravenous Morphine Consumption
Tidsramme: Postoperative 0-8, 8-16, and 16-24 hours
Intravenous morphine consumption recorded separately for postoperative 0-8, 8-16, and 16-24 hour intervals.
Postoperative 0-8, 8-16, and 16-24 hours
Right Hemidiaphragm Excursion
Tidsramme: Preoperative and postoperative 6 hours
Right hemidiaphragm excursion measured by ultrasonography to evaluate diaphragmatic function.
Preoperative and postoperative 6 hours
Peak Expiratory Flow
Tidsramme: Preoperative and postoperative 6 hours
Peak expiratory flow measured using a peak flowmeter to evaluate respiratory performance.
Preoperative and postoperative 6 hours
Quality of Recovery-15 Score
Tidsramme: Postoperative 24 hours
Postoperative recovery quality assessed using the Quality of Recovery-15 (QoR-15) questionnaire.
Postoperative 24 hours

Samarbejdspartnere og efterforskere

Det er her, du vil finde personer og organisationer, der er involveret i denne undersøgelse.

Sponsor

Ferit Yetik

Samarbejdspartnere

Bursa Sehir Hastanesi

Datoer for undersøgelser

Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.

Studer store datoer

Studiestart (Anslået)

1. juni 2026

Primær færdiggørelse (Anslået)

1. december 2026

Studieafslutning (Anslået)

1. december 2026

Datoer for studieregistrering

Først indsendt

12. juni 2026

Først indsendt, der opfyldte QC-kriterier

12. juni 2026

Først opslået (Faktiske)

17. juni 2026

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

17. juni 2026

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

12. juni 2026

Sidst verificeret

1. juni 2026

Mere information

Begreber relateret til denne undersøgelse

Nøgleord

Yderligere relevante MeSH-vilkår

Andre undersøgelses-id-numre

  • 26-AKD-150
  • 2025-KAEK-47 (Anden identifikator: Bursa City Hospital Clinical Research Ethics Committee)

Plan for individuelle deltagerdata (IPD)

Planlægger du at dele individuelle deltagerdata (IPD)?

UBESLUTET

IPD-planbeskrivelse

Individual participant data (IPD) sharing has not yet been determined. The decision regarding data sharing will be made after study completion and in accordance with institutional policies, ethical considerations, and participant confidentiality requirements.

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Kliniske forsøg med Postoperativ smerte

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