Comparison Of The Analgesic Effectiveness Of Ultrasonography-Guided Serratus Posterıor Superior Intercostal Plane (SPSIP) Block And Intercostal Nerve (ICN) Block In Video-Assisted Thoracoscopic Surgery Patients
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 发起方
- 入组人数
- 82
- 试验地点
- 1
- 主要终点
- Postoperative pain intensity
研究概览
简要总结
This study aims to evaluate the effectiveness of Serratus Posterior Superior Intercostal Plane (SPSIP) block compared to Intercostal Nerve (ICN) block in terms of postoperative pain control, reduction of opioid analgesic consumption, minimization of postoperative respiratory complications, and increase patient satisfaction (using a 5-point Likert scale) in patients undergoing video-assisted thoracoscopic surgery (VATS).
详细描述
In this prospective observational study, patients included in the study will receive Serratus Posterior Superior Intercostal Plane (SPSIP) block and Intercostal Nerve (ICN) block for postoperative analgesia at the end of surgery. The SPSIP block will be performed by the anesthesiologist under ultrasound guidance immediately after skin closure and before extubation, while the ICN block will be performed by the surgeon under direct vision immediately before skin closure.
At the end of surgery, patients will receive 1000 mg paracetamol and 50 mg dexketoprofen during skin closure. Upon arrival at the recovery room, each patient will be connected to a patient-controlled analgesia (PCA) pump containing tramadol. At postoperative reassessment, patients with a Numerical Pain Rating Scale (NPRS) score greater than 4 despite PCA use will receive a rescue analgesic dose of 50 mg dexketoprofen.
Postoperative pain intensity will be assessed using the NPRS (Numerical Pain Rating Scale) at 1, 4, 6, 12, 18, and 24 hours postoperatively, both at rest and during coughing. Total opioid consumption, rescue analgesic use, and postoperative complications will be recorded.
Patients will be informed about their level of surgical satisfaction 24 hours after surgery, and this information will be recorded.
研究设计
- 研究类型
- Observational
- 观察模型
- Case Control
- 时间视角
- Prospective
入排标准
- 年龄范围
- 18 Years 至 80 Years（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Aged 18-80 years,
- •American Society of Anesthesiologists (ASA) physical status I-III
- •Patients who have provided informed consent to participate in the study
排除标准
- •Patients who refuse to participate in the study by not signing the informed consent
- •Patients classified as ASA > 3, according to the system established by the American Society of Anesthesiologists
- •Patients unable to understand the use of the NPR Scale or the PCA device that will be used for postoperative analgesia
- •Coagulation disorders or anticoagulant therapy contraindicating regional anesthesia
- •Patients with allergies to analgesic and/or anesthetic drugs
- •Infection at the block injection site
- •Patients whose surgical procedure is intraoperatively converted to an open pulmonary resection
研究组 & 干预措施
Group SPSIP Block
In patients meeting the inclusion criteria for the study, an ultrasound-guided interfacial plane block is applied between the posterior superior serratus muscle and the underlying ribs in patients undergoing SPSIP block after VATS.
Group ICN Block
Patients meeting the inclusion criteria for the study who will undergo intercostal nerve block after VATS will have a total of 10 ml of 0.5% bupivacaine applied to two segments (upper and lower segments of the incision line) under direct vision by the surgeon while the patient is in the lateral decubitus position at the end of the operation and immediately before skin closure.
结局指标
主要结局
Postoperative pain intensity
时间窗: 24 hours after the end of surgery
In both study groups, postoperative pain intensity at rest and with coughing was measured using the Numerical Pain Rating Scale (NPRS), a numerical scale ranging from 0 to 10 (0 meaning no pain, 10 meaning the most severe pain imaginable).
次要结局
- Total opioid drug consumption(24 hours after the end of surgery)
- Consumption of rescue analgesics(24 hours after the end of surgery)
- Postoperative Complications(24 hours after the end of surgery)
- Patient satisfaction score(At the 24th hour post-operation)
研究者
Abdullah Bozkurt
MD
Kocaeli City Hospital