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- Essai clinique NCT07655336
SPSIP Versus RISS Block in Volume-Preserving VATS (SRVATS)
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
Aperçu de l'étude
Statut
Les conditions
Description détaillée
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.
Type d'étude
Inscription (Estimé)
Phase
- N'est pas applicable
Contacts et emplacements
Coordonnées de l'étude
- Nom: Yusuf Alan
- Numéro de téléphone: +905396210977
- E-mail: dryusufalan@gmail.com
Lieux d'étude
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Nilüfer
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Bursa, Nilüfer, Turquie (Türkiye), 16100
- Recrutement
- Bursa City Hospital
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Contact:
- Yusuf Alan, MD
- Numéro de téléphone: 05396210977
- E-mail: dryusufalan@gmail.com
-
Chercheur principal:
- Yusuf Alan, MD
-
Sous-enquêteur:
- Onur Güneş, MD
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Sous-enquêteur:
- Halil ERTEK, MD
-
-
Critères de participation
Critère d'éligibilité
Âges éligibles pour étudier
- Adulte
- Adulte plus âgé
Accepte les volontaires sains
La description
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
Plan d'étude
Comment l'étude est-elle conçue ?
Détails de conception
- Objectif principal: Traitement
- Répartition: Randomisé
- Modèle interventionnel: Affectation parallèle
- Masquage: Quadruple
Armes et Interventions
Groupe de participants / Bras |
Intervention / Traitement |
|---|---|
|
Expérimental: 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).
|
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.
|
|
Expérimental: 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).
|
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.
|
Que mesure l'étude ?
Principaux critères de jugement
Mesure des résultats |
Description de la mesure |
Délai |
|---|---|---|
|
Incidence of Somatic Pain at Chest Tube Insertion Site
Délai: 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
|
Mesures de résultats secondaires
Mesure des résultats |
Description de la mesure |
Délai |
|---|---|---|
|
Postoperative Pain Scores at Rest
Délai: 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
Délai: 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
Délai: Postoperative 24 hours
|
Total intravenous morphine consumption during the first 24 hours after surgery.
|
Postoperative 24 hours
|
|
Interval Intravenous Morphine Consumption
Délai: 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
Délai: Preoperative and postoperative 6 hours
|
Right hemidiaphragm excursion measured by ultrasonography to evaluate diaphragmatic function.
|
Preoperative and postoperative 6 hours
|
|
Peak Expiratory Flow
Délai: 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
Délai: Postoperative 24 hours
|
Postoperative recovery quality assessed using the Quality of Recovery-15 (QoR-15) questionnaire.
|
Postoperative 24 hours
|
Collaborateurs et enquêteurs
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Collaborateurs
Dates d'enregistrement des études
Dates principales de l'étude
Début de l'étude (Réel)
Achèvement primaire (Estimé)
Achèvement de l'étude (Estimé)
Dates d'inscription aux études
Première soumission
Première soumission répondant aux critères de contrôle qualité
Première publication (Réel)
Mises à jour des dossiers d'étude
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Dernière vérification
Plus d'information
Termes liés à cette étude
Mots clés
Termes MeSH pertinents supplémentaires
Autres numéros d'identification d'étude
- 26-AKD-150
- 2025-KAEK-47 (Autre identifiant: Clinical Research Ethics Committee of University of Health Sciences Bursa Faculty of Medicine)
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