SPSIP Block and Opioid Use After MICS
Evaluation of the Effectiveness of Serratus Posterior Superior Intercostal Plane Block in Perioperative Pain Management in Patients Undergoing Minimally Invasive Cardiac Surgery
Ankara City Hospital Bilkent
50 participants
Jan 22, 2026
INTERVENTIONAL
Conditions
Summary
This prospective, randomized, controlled, single-center clinical study aims to evaluate the effectiveness of the Serratus Posterior Superior Intercostal Plane Block (SPSIPB) in perioperative pain management among patients undergoing minimally invasive cardiac surgery (MICS). A total of 50 patients undergoing MICS will be randomized into two groups: one receiving standard analgesia plus ultrasound-guided SPSIPB with 30 mL of 0.25% bupivacaine, and a control group receiving standard analgesia only. The primary outcome is total postoperative opioid consumption within 24 hours. Secondary outcomes include postoperative pain scores, extubation time, block-related complications, and recovery parameters such as early mobilization, oral intake, Modified radiological atelectasis score and Quality of Recovery-15 scores.
Eligibility
Inclusion Criteria5
- Patients scheduled for minimally invasive cardiac surgery (MICS)
- Age between 18 and 75 years
- American Society of Anesthesiologists (ASA) physical status II-III
- Body mass index (BMI) between 18 and 35 kg/m²
- Patients who provide written informed consent for participation
Exclusion Criteria10
- Known allergy or hypersensitivity to local anesthetics
- Coagulopathy or current anticoagulant therapy
- Pregnancy or breastfeeding
- Impaired consciousness or inability to communicate
- Failed or technically inadequate block
- Refusal to undergo the block procedure
- Cognitive or mental disorders preventing valid pain assessment
- Opioid intolerance or contraindication to opioid use
- Development of intraoperative or postoperative complications requiring reoperation, prolonged mechanical ventilation, or intensive care
- Incomplete postoperative data or patient withdrawal from the study
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Interventions
The SPSIPB will be performed under ultrasound guidance using an in-plane technique. The needle will be advanced into the fascial plane between the serratus posterior superior and intercostal muscles at the 2nd-3rd intercostal level, and 30 mL of 0.25% bupivacaine will be injected unilaterally on the surgical side. This procedure will be applied in addition to standard anesthesia and analgesia.
The same ultrasound-guided procedure will be performed using identical technique and needle placement, but 30 mL of normal saline will be injected instead of local anesthetic. This sham block will be performed to maintain blinding, while all other anesthesia and analgesia protocols will be identical to the experimental group.
Locations(1)
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NCT07259824