Serratus Posterior Superior Intercostal Plane Block in Robotic-Assisted Thymectomy
Use of Serratus Posterior Superior Intercostal Plane Block in Robotic-Assisted Thoracoscopic Surgery for Thymectomy: A Randomized Controlled Trial
Fondazione Policlinico Universitario Agostino Gemelli IRCCS
28 participants
Mar 1, 2025
INTERVENTIONAL
Conditions
Summary
This study aims to assess the effectiveness of the Serratus Posterior Superior Intercostal Plane Block (SPSIP Block) for postoperative pain control, reducing opioid analgesic consumption, minimizing postoperative respiratory complications, and enhancing patient satisfaction (measured using the QoR-15 index) in patients undergoing robotic thymectomy, compared to patients who do not receive the block.
Eligibility
Inclusion Criteria1
- Patients affected by thymoma, thymic hyperplasia, or thymic pathologies (cysts, teratomas) who have given informed consent to the study.
Exclusion Criteria11
- Patients who refuse to participate in the study by not signing the informed consent;
- Patients with myasthenia gravis, severe obesity (BMI \> 35), history of OSAS with or without CPAP;
- Patients belonging to ASA classes \> 3, according to the system developed by the American Society of Anesthesiologists;
- Patients unable to understand the functioning of the NPR Scale or the PCA device that will be used for postoperative analgesia;
- Patients with allergies to analgesic and/or anesthetic drugs;
- Patients on anticoagulant therapy;
- Patients with a history of chronic pain;
- Patients with an infection at the site where SPSIPB will be performed;
- Patients who have had previous thoracic surgery and/or thoracic trauma with rib fractures on the side of the surgery;
- Patients with chest deformities and/or neuromuscular diseases that interfere with normal ventilatory function.
- Additionally, patients whose surgery is intraoperatively converted to sternotomy thymectomy will be excluded post-hoc from the study.
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Interventions
While the patient is in the prone or the sitting position, a high-frequency linear transducer is placed transversely at the level of the scapular spine, visualizing the upper medial border of the scapula, trapezius muscle, rhomboid major, serratus posterior superior muscle, and the second and third ribs. Next, the transducer is rotated to obtain an oblique view, including the upper medial border of the scapula. The needle is then advanced immediately medial to the scapula, aiming for the area between the second and third ribs to reach the fascial plane between the serratus posterior superior muscle and intercostal muscles using the in-plane technique. Once the needle contacts the rib, 30 mL of 0.25% bupivacaine is administered superficially to the intercostal muscle.
While the patient is in the prone or the sitting position, a high-frequency linear transducer is placed transversely at the level of the scapular spine, visualizing the upper medial border of the scapula, trapezius muscle, rhomboid major, serratus posterior superior muscle, and the second and third ribs. Next, the transducer is rotated to obtain an oblique view, including the upper medial border of the scapula. The needle is then advanced immediately medial to the scapula, aiming for the area between the second and third ribs to reach the fascial plane between the serratus posterior superior muscle and intercostal muscles using the in-plane technique. Once the needle contacts the rib, 30 mL of 0.9% NaCl is administered superficially to the intercostal muscle
Locations(1)
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NCT06545409