Combined SAPB in MICS

Not Applicable

Completed

• Conditions: Acute Pain; Serratus Anterior Plane Block; Minimal Invasive Cardiac Surgery; Postoperative Analgesia

• Registration Number: NCT06326320
• Lead Sponsor: Ankara City Hospital Bilkent

Brief Summary

Minimally invasive cardiac surgery (MICS) has begun to be performed frequently in recent years. Compared to sternotomy, MISC reduces the risk of mediastinitis, leaves a more aesthetic scar, facilitates postoperative rehabilitation, and shortens the hospital stay. MICS requires a thoracic incision in the right 4th or 5th intercostal space. This incision causes intense and long-lasting pain in the postoperative period. Pain is exacerbated by breathing movements, coughing, and respiratory physiotherapy.

Postoperative analgesia is a critical risk factor for the development of pulmonary and cardiovascular complications in any type of cardiothoracic surgery. If patients with high pain levels cannot breathe effectively, it may lead to atelectasis, cardiac ischemia, and arrhythmias. This prolongs the time it takes for patients to be discharged and increases the frequency of postoperative pulmonary complications and postoperative morbidity.

In addition to intravenous medications, various neuraxial and peripheral nerve blocks can be used in cardiac surgery. In recent years, thoracic epidural analgesia has been avoided due to the use of intraoperative high-dose heparin. As an alternative, peripheral nerve blocks have recently gained popularity. SAPB is one of them. SAPB can be applied in three ways. While deep SAPB (DSAPB) is applied under the serratus anterior muscle, superficial SAPB (SSAPB) is applied above the serratus anterior muscle. Combined SAPB (CSAPB) is applied both below and above the serratus anterior muscle. These blocks can be performed with a single injection anywhere between the second and seventh ribs on the lateral chest wall.

In this study, the analgesic effects of ultrasound-guided CSAPB application in patients undergoing MICS will be evaluated.

Detailed Description

Not available

Study Timeline

• Study Start: 2024-02-07
• Study First Submitted: 2024-03-17
• Study First Submitted QC: 2024-03-17
• Study First Posted: 2024-03-22
• Primary Completion: 2025-06-10
• Study Completion: 2025-06-25
• Status Verified: 2025-07
• Last Update Submitted: 2025-07-10
• Last Update Posted: 2025-07-11

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 20

Inclusion Criteria

• 18 to 80 years old
• American Society of Anesthesiologists (ASA) physical status I-II-III
• BMI 18 to 40 kg/m2
• Elective Minimally Invasive Cardiac Surgery (MICS)

Exclusion Criteria

• Patient refusing the procedure
• Emergency surgery
• History of chronic opioid or analgesic used

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: SINGLE_GROUP

Primary Outcome Measures

Name	Time	Method
Pain Scores	12th hour the extubation	After the extubation, pain will be assessed for the sternum and the drain area at the 12th-hour rest and while coughing using the visual analog scale on a scale from 0 (no pain) to 10 (worst pain).

Secondary Outcome Measures

Name	Time	Method
Remifentanyl Consumption	intraoperative period	Remifentanyl consumption for intraoperative period will be recorded

Trial Locations

Locations (1)

Ankara City Hospital; 🇹🇷 Çankaya, Ankara, Turkey