ESPB vs SPSIP for Postoperative Analgesia After CABG
A Randomized Trial Comparing Erector Spinae Plane Block Versus Serratus Posterior Superior Intercostal Plane Block for Postoperative Analgesic Efficacy in Patients Undergoing Coronary Artery Bypass Graft Surgery
Kutahya Health Sciences University
64 participants
Mar 1, 2026
INTERVENTIONAL
Conditions
Summary
This prospective, randomized, active-controlled, double-blind, parallel-group study compares the postoperative analgesic efficacy and safety of ultrasound-guided bilateral Erector Spinae Plane Block (ESPB) versus bilateral Serratus Posterior Superior Intercostal Plane Block (SPSIPB) in adult patients (45-85 years, ASA I-III) undergoing elective coronary artery bypass graft surgery. The primary outcome is postoperative pain intensity assessed by Numeric Rating Scale (NRS) at 2, 4, 8, 16, 24, and 48 hours after surgery. Secondary outcomes include intraoperative fentanyl/remifentanil consumption, postoperative morphine consumption, patient-controlled analgesia (PCA) demand/delivery parameters (if PCA is used), need for rescue analgesics, extubation and mobilization times, peak inspiratory flow measured by incentive spirometry at predefined time points, ICU and hospital length of stay, recovery quality (QoR-15 at 0, 24, and 48 hours), mortality, and block-related adverse events.
Eligibility
Inclusion Criteria4
- Age 45-85 years
- Scheduled for elective coronary artery bypass graft (CABG) surgery
- American Society of Anesthesiologists (ASA) I-II-III
- Patients who provide written informed consent and agree to participate in the study
Exclusion Criteria7
- Emergency cases
- ASA IV-V
- Known allergy to local anesthetics
- Coagulopathy (platelet count <100,000/mm³, INR >1.5, aPTT >1.5× normal)
- Infection at the block injection site
- Pregnancy
- Patients who do not provide written informed consent or decline to participate after being informed
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Interventions
Bilateral ultrasound-guided ESPB performed preoperatively under sedation at the T4-T5 transverse process level using 20 mL of 0.25% bupivacaine per side (total 40 mL).
Bilateral ultrasound-guided SPSIPB performed preoperatively under sedation at the 2nd-3rd intercostal space using 20 mL of 0.25% bupivacaine per side (total 40 mL).
Locations(1)
View Full Details on ClinicalTrials.gov
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NCT07388745