SPSIPB Versus SAPB for Postoperative Analgesia After Minimally Invasive Repair of Pectus Excavatum
Comparison of the Postoperative Analgesic Effects of Serratus Posterior Superior Intercostal Plane Block and Serratus Anterior Plane Block After Minimally Invasive Repair of Pectus Excavatum: A Prospective Observational Cohort Study
研究概览
地位
详细说明
Pectus excavatum is the most common chest wall deformity in pediatric and adolescent patients and is characterized by posterior depression of the sternum and anterior chest wall. Although many patients are asymptomatic, corrective surgery is frequently performed during adolescence or young adulthood for cosmetic reasons and to improve body image and quality of life.
Minimally invasive repair of pectus excavatum involves the placement of a curved metal bar beneath the sternum. The bar is then rotated to elevate the sternum and correct the chest wall deformity. Despite favorable cosmetic and quality-of-life outcomes, postoperative pain remains a major clinical challenge after this procedure. Pain is mainly related to sternal elevation, pressure exerted by the bar, and repositioning of the ribs. Inadequate pain control may increase opioid consumption and prolong hospitalization. Higher opioid exposure may also lead to adverse effects such as nausea, vomiting, constipation, pruritus, and urinary retention.
Regional anesthesia techniques have become important components of multimodal postoperative analgesia in thoracic surgery. Thoracic paravertebral block, erector spinae plane block, and serratus anterior plane block are among the regional techniques commonly used for thoracic analgesia. Serratus anterior plane block has also been used for postoperative pain management after minimally invasive repair of pectus excavatum.
Serratus posterior superior intercostal plane block is a recently described ultrasound-guided interfascial plane block. The technique involves injection of local anesthetic between the serratus posterior superior muscle and the rib, usually at the level of the second or third rib. This block has been reported to provide analgesia in various thoracic and scapular pain conditions and has shown promising results in thoracic surgery.
The aim of this study is to compare the postoperative analgesic outcomes of serratus posterior superior intercostal plane block and serratus anterior plane block in patients undergoing minimally invasive repair of pectus excavatum. Because this is an observational study, the choice of regional analgesia technique will not be determined by the study protocol. The block technique will be selected by the attending anesthesiologist according to routine clinical practice. No randomization or protocol-driven assignment will be performed.
研究类型
注册 (估计的)
联系人和位置
学习联系方式
- 姓名：Cem Özdemir, MD
- 电话号码：+905385027687
- 邮箱：suskungeveze.cem@gmail.com
研究联系人备份
- 姓名：Seniyye Ülgen Zengin, Associate Professor, MD
- 电话号码：+905057142443
- 邮箱：ulgen_t@yahoo.com
学习地点
-
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Istanbul
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Istanbul、Istanbul、土耳其（türkiye）、34722
- 招聘中
- Marmara University
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接触：
- Cem Özdemir, MD
- 电话号码：+905385027687
- 邮箱：suskungeveze.cem@gmail.com
-
接触：
- Seniyye Ülgen Zengin, Associate Professor, MD
- 电话号码：+905057142443
- 邮箱：ulgen_t@yahoo.com
-
首席研究员：
- Seniyye Ülgen Zengin, Associate Professor, MD
-
副研究员：
- Cem Özdemir, MD
-
副研究员：
- Meliha Orhon Ergün, Associate Professor, MD
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-
参与标准
资格标准
适合学习的年龄
- 孩子
- 成人
接受健康志愿者
取样方法
研究人群
描述
Inclusion Criteria:
- Patients aged 15 to 25 years
- Diagnosis of pectus excavatum
- Scheduled to undergo minimally invasive repair of pectus excavatum under general anesthesia
- Receipt of either bilateral serratus posterior superior intercostal plane block or bilateral serratus anterior plane block as part of routine perioperative analgesic care
- Written informed consent obtained from the patient or, for patients younger than 18 years, from a legal guardian
Exclusion Criteria:
- Refusal to participate in the study
- Contraindication to regional anesthesia
- Known allergy to local anesthetics or study analgesic medications
- Chronic opioid use
- Pre-existing chronic pain syndrome
- Coagulopathy or use of anticoagulant therapy that contraindicates regional block application
- Local infection at the block injection site
- Neurological or psychiatric condition that may interfere with pain assessment
- Incomplete perioperative or postoperative data
- Conversion to another surgical technique or major intraoperative complication requiring a change in the routine analgesic protocol
学习计划
研究是如何设计的？
设计细节
队列和干预
团体/队列 |
干预/治疗 |
|---|---|
|
Serratus Anterior Plane Block Group
Participants in this cohort will receive bilateral ultrasound-guided serratus anterior plane block as part of routine perioperative analgesic care.
|
持续术中采用脑电双频指数（BIS）设备监测麻醉深度。
整个手术过程中记录BIS数值，以协助麻醉药物的滴定调整，并使不同研究队列的麻醉深度标准化。
BIS设备仅用于监测目的，不执行任何与设备相关的研究性操作。
其他名称：
All participants will receive a standardized multimodal postoperative analgesia protocol.
Patient-controlled analgesia with intravenous morphine will be used.
The device will be programmed to administer 1 mg of intravenous morphine per demand, with a lockout interval of 10 minutes.
Paracetamol will be administered as part of routine multimodal analgesia.
If adequate analgesia cannot be achieved, 100 mg tramadol will be administered as rescue analgesia according to clinical need.
Bilateral ultrasound-guided serratus anterior plane block will be performed according to standard techniques described in the literature and routinely used in the clinic.
Local anesthetic dosing will be determined according to institutional practice and safety limits.
In bilateral applications, the total bupivacaine dose will not exceed 2.5 mg/kg.
其他名称：
|
|
Serratus Posterior Superior Intercostal Plane Block Group
Participants in this cohort will receive bilateral ultrasound-guided serratus posterior superior intercostal plane block as part of routine perioperative analgesic care.
|
持续术中采用脑电双频指数（BIS）设备监测麻醉深度。
整个手术过程中记录BIS数值，以协助麻醉药物的滴定调整，并使不同研究队列的麻醉深度标准化。
BIS设备仅用于监测目的，不执行任何与设备相关的研究性操作。
其他名称：
All participants will receive a standardized multimodal postoperative analgesia protocol.
Patient-controlled analgesia with intravenous morphine will be used.
The device will be programmed to administer 1 mg of intravenous morphine per demand, with a lockout interval of 10 minutes.
Paracetamol will be administered as part of routine multimodal analgesia.
If adequate analgesia cannot be achieved, 100 mg tramadol will be administered as rescue analgesia according to clinical need.
Bilateral ultrasound-guided serratus posterior superior intercostal plane block will be performed according to standard techniques described in the literature and routinely used in the clinic.
Local anesthetic dosing will be determined according to institutional practice and safety limits.
In bilateral applications, the total bupivacaine dose will not exceed 2.5 mg/kg.
其他名称：
|
研究衡量的是什么？
主要结果指标
结果测量 |
措施说明 |
大体时间 |
|---|---|---|
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Total postoperative opioid consumption during the first 24 hours
大体时间：From the end of surgery to 24 hours postoperatively
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Total opioid consumption during the first 24 hours after surgery will be recorded and expressed as intravenous morphine equivalents in milligrams.
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From the end of surgery to 24 hours postoperatively
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次要结果测量
结果测量 |
措施说明 |
大体时间 |
|---|---|---|
|
Intraoperative opioid consumption
大体时间：From induction of anesthesia to the end of surgery
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Total intraoperative opioid consumption will be recorded.
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From induction of anesthesia to the end of surgery
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Postoperative pain scores
大体时间：At arrival in the post-anesthesia care unit and at postoperative 6, 12, 24, and 48 hours
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Pain intensity will be assessed using the Numeric Rating Scale, where 0 indicates no pain and 10 indicates the worst imaginable pain.
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At arrival in the post-anesthesia care unit and at postoperative 6, 12, 24, and 48 hours
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Patient satisfaction
大体时间：At postoperative 6, 12, 24, and 48 hours
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Patient satisfaction with postoperative analgesia will be assessed using a 4-point Likert scale, where 0 indicates very dissatisfied and 3 indicates very satisfied.
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At postoperative 6, 12, 24, and 48 hours
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Incidence of Opioid-Related Adverse Effects
大体时间：From the end of surgery to 48 hours postoperatively
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Presence of nausea, vomiting, pruritus, constipation, urinary retention, sedation, and respiratory depression.
Adverse effects will be compared among the two groups.
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From the end of surgery to 48 hours postoperatively
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Duration of anesthesia
大体时间：Intraoperative period
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The total duration of anesthesia will be recorded in minutes.
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Intraoperative period
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Duration of surgery
大体时间：Intraoperative period
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The total duration of surgery will be recorded in minutes.
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Intraoperative period
|
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Time to mobilization
大体时间：From the end of surgery until the first documented ambulation, assessed within the first 48 postoperative hours
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The time from the end of surgery to first mobilization will be recorded.
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From the end of surgery until the first documented ambulation, assessed within the first 48 postoperative hours
|
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Length of hospital stay
大体时间：Length of postoperative hospital stay, defined as the time from the end of surgery to hospital discharge, assessed up to 30 days postoperatively
|
The duration of postoperative hospitalization will be recorded.
|
Length of postoperative hospital stay, defined as the time from the end of surgery to hospital discharge, assessed up to 30 days postoperatively
|
合作者和调查者
调查人员
- 学习椅：Cem Özdemir, MD、Marmara University
- 首席研究员：Seniyye Ülgen Zengin, Associate Professor, MD、Marmara University
- 研究主任：Meliha Orhon Ergün, Associate Professor, MD、Marmara University
研究记录日期
研究主要日期
学习开始 (实际的)
初级完成 (估计的)
研究完成 (估计的)
研究注册日期
首次提交
首先提交符合 QC 标准的
首次发布 (实际的)
研究记录更新
最后更新发布 (实际的)
上次提交的符合 QC 标准的更新
最后验证
更多信息
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关键字
其他相关的 MeSH 术语
其他研究编号
- 09.2026.769
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