RecruitingNot ApplicableNCT07540104

Serratus Posterior Superior Intercostal Plane Block Versus Intrathecal Morphine in VATs

Comparison of the Effects of Serratus Posterior Superior Intercostal Plane Block and Intrathecal Morphine on Postoperative Acute Pain in Patients Undergoing Video-assisted Thoracoscopic Surgery

Sponsor

Ondokuz Mayıs University

Enrollment

60 participants

Start Date

Apr 15, 2026

Study Type

INTERVENTIONAL

Conditions

Postoperative Pain Video Assisted Thoracic Surgery (VATS)Thoracic Anesthesia

Summary

This study aims to compare the analgesic effects of the serratus posterior superior intercostal plane block and intrathecal morphine in patients undergoing video-assisted thoracoscopic surgery. This is a prospective, randomized, controlled, single-center clinical trial including adult patients undergoing elective thoracoscopic surgery. Participants will be randomly assigned to receive either a serratus posterior superior intercostal plane block or intrathecal morphine before general anesthesia. The primary outcome is cumulative opioid consumption during the first 24 postoperative hours, expressed as intravenous morphine milligram equivalents. Secondary outcomes include pain scores, time to first analgesic request, quality of recovery, and postoperative complications. The study aims to determine whether these two techniques differ in their effectiveness for postoperative pain management.

Eligibility

Min Age: 18 YearsMax Age: 75 Years

Inclusion Criteria3

Age between 18 and 75 years
American Society of Anesthesiologists physical status I to III
Scheduled for elective video-assisted thoracoscopic surgery including wedge resection, segmentectomy, or lobectomy

Exclusion Criteria14

Refusal to participate
Pregnancy
Morbid obesity (body mass index greater than 40 kg per square meter)
Allergy to opioids, local anesthetics, or nonsteroidal anti-inflammatory drugs
Neuropsychiatric disorders, cognitive impairment, or inability to communicate
History of substance abuse
Use of anticoagulant therapy or presence of bleeding disorders
Active systemic infection
Severe cardiovascular, hepatic, renal, or endocrine disease
Chronic pain syndrome or ongoing chronic pain treatment
Emergency surgery or prior ipsilateral thoracic surgery
Preoperative opioid use
Significant intraoperative or postoperative bleeding or hemodynamic instability
Requirement for prolonged postoperative mechanical ventilation longer than 18 hours

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Interventions

PROCEDUREIntrathecal Morphine

Intrathecal morphine is administered at a dose of 5 micrograms per kilogram diluted in 3 milliliters of saline via spinal injection at the lumbar level before induction of general anesthesia.

PROCEDURESerratus Posterior Superior Intercostal Plane Block

Ultrasound-guided serratus posterior superior intercostal plane block is performed before induction of general anesthesia using 30 milliliters of 0.25 percent bupivacaine with epinephrine injected into the interfascial plane between the serratus posterior superior muscle and intercostal muscles.