Comparison of the Effects of Ultrasound-Guided Rhomboid Intercostal Block and Serratus Posterior Superior Intercostal Plane Block on Postoperative Acute Pain in Patients Undergoing Video-Assisted Thoracoscopic Surgery
Trial Snapshot
- Phase
- Not Applicable
- Status
- Recruiting
- Sponsor
- Ankara City Hospital Bilkent
- Enrollment
- 90
- Locations
- 1
- Primary Endpoint
- Surgical Pain Scores
Study Overview
Brief Summary
Video-assisted thoracic surgery (VATS) is widely performed for the management of various thoracic pathologies and is generally associated with reduced surgical trauma compared with open thoracotomy. Nevertheless, patients may still experience considerable postoperative pain, which can adversely affect respiratory function, mobilization, and recovery. Various regional analgesic techniques have been incorporated into multimodal pain management strategies for VATS, including thoracic paravertebral block (TPVB), erector spinae plane block (ESPB), intercostal nerve block, serratus anterior plane block (SAPB), rhomboid intercostal block (RIB), and serratus posterior superior intercostal plane block (SPSIPB). Among these approaches, ultrasound-guided TPVB has traditionally been regarded as a reference regional analgesic technique. More recently, interfascial plane blocks have gained increasing attention because of their technical simplicity and favorable safety profile. RIB and SPSIPB are two novel interfascial plane blocks that may provide effective postoperative analgesia following thoracic surgery. The present study aims to compare the analgesic efficacy of RIB and SPSIPB in patients undergoing VATS and to evaluate their impact on postoperative pain outcomes.
Study Design
- Study Type
- Interventional
- Allocation
- Randomized
- Intervention Model
- Parallel
- Primary Purpose
- Treatment
- Masking
- Double (Participant, Outcomes Assessor)
Eligibility Criteria
- Ages
- 18 Years to 75 Years (Adult, Older Adult)
- Sex
- All
- Accepts Healthy Volunteers
- No
Inclusion Criteria
- •Patients undergoing elective VATS
- •Patients aged 18-75 years
- •Patients with ASA (American Society of Anesthesiologists) class I-III
- •Patients who have given informed consent
Exclusion Criteria
- •Patients allergic to local anesthetics
- •Patients with bleeding disorders or those undergoing anticoagulant therapy
- •Pregnant and breastfeeding women
- •Patients with impaired consciousness, inability to communicate, or mental/cognitive impairment
- •Patients who refuse block application
- •Patients with infection in the area where the block will be applied
Arms & Interventions
Rhomboid Intercostal Block
For patients scheduled to receive a Rhomboid Intercostal Block (RIB), after sonographic identification of the relevant anatomical structures, the block needle is advanced using an in-plane ultrasound-guided technique beneath the rhomboid muscle until contact with the rib is achieved. Following hydrodissection with 2 mL of normal saline to confirm correct needle placement, 30 mL of 0.25% bupivacaine is injected into the interfascial plane.
Intervention: Rhomboid Intercostal Block (Drug)
Serratus Posterior Superior Intercostal Plane Block
For patients scheduled to receive a Serratus Posterior Superior Intercostal Plane Block (SPSIPB), after sonographic identification of the relevant anatomical structures, the block needle is advanced using an in-plane ultrasound-guided technique beneath the serratus posterior superior muscle until contact with the rib is achieved. Following hydrodissection with 2 mL of normal saline to confirm correct needle placement, 30 mL of 0.25% bupivacaine is injected into the interfascial plane.
Intervention: Serratus Posterior Superior Intercostal Plane Block (Drug)
Outcomes
Primary Outcomes
Surgical Pain Scores
Time Frame: 24 hours after surgery
Surgical pain will be assessed at rest and while coughing using the visual analog scale on a scale from 0mm (no pain) to 100mm (worst pain). Pain assessment will be done at 1st, 6th, 12th, and 24th hours after surgery.
Secondary Outcomes
- Shoulder Pain Scores(24 hours after surgery)
- Intraoperative remifentanil consumption(During the intraoperative period)
Investigators
Nilgün Zengin
Principal İnvestigator
Ankara City Hospital Bilkent