SPS Block vs. Surgical Intercostal Block for Chronic Pain After Thoracoscopic Surgery
For patients and families
In plain language
An automatic summary of structured registry data. It is an orientation aid, not a substitute for the official protocol or a physician assessment.
- What is being studied
- The protocol lists: SPS block, Surgical Intercostal Blockade..
- Who it may be relevant to
- Registry conditions: Chronic Post-thoracotomy Pain, Neuropathic Pain, Postoperative Pain, Acute. Basic parameters: 18 years — 75 years · All.
- What needs checking
- Age, condition and sex are only basic indicators. Prior treatment, laboratory values and other mandatory requirements appear in the eligibility criteria below.
- Where it takes place
- Turkey (Türkiye)
- Next step
- Save the trial, show it to the treating physician, and confirm current recruitment with the study center. Costs, documents and travel →
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Official title
Evaluation of Serratus Posterior Superior (SPS) Block Versus Surgical Intercostal Blockade in Preventing Chronic Post-Thoracotomy Pain After Video-Assisted Thoracoscopic Surgery (VATS): A Randomized, Prospective, Comparative Study.
Overview
This study aims to evaluate the efficacy of ultrasound-guided Serratus Posterior Superior (SPS) block compared to surgeon-administered intercostal blockade in preventing chronic pain at 3, 6, and 12 months following Video-Assisted Thoracoscopic Surgery (VATS).
Detailed description
Although VATS is a minimally invasive technique, chronic post-thoracotomy pain (CPTP) remains a significant complication due to intercostal nerve injury. This study investigates whether the preemptive analgesic effect of the SPS block, performed under ultrasound guidance before surgery, reduces the incidence and severity of chronic pain more effectively than standard surgical intercostal blocks. Secondary objectives include assessing acute pain scores (VAS/NRS) within the first 24 hours, total opioid consumption, and duration of hospital stay.
Interventions
- Drug SPS block
30 mL of 0.25% Bupivacaine will be injected into the plane between the Serratus Posterior Superior muscle and the intercostal muscles at the scapular level. - Drug Surgical Intercostal Blockade.
At the end of the operation, the surgeon will perform an injection of a total of 30 mL of 0.25% Bupivacaine into three intercostal nerves above and below the incision site under direct thoracoscopic visualization.
Primary outcome measures
- Incidence and severity of Chronic Post-Thoracotomy Pain (CPTP) [Time frame: Incidence and severity of Chronic Post-Thoracotomy Pain (CPTP) at 3, 6, and 12 months post-surgery.]
Secondary outcome measures (5)
- Opioid consumption (Fentanyl PCA) [Time frame: Changes from baseline opioid consumption at postoperative 1, 2, 4, 8, 16 and 24 hours.]
- Pain scores (Numerical rating scale-NRS) [Time frame: Changes from baseline pain scores at postoperative 1, 2, 4, 8, 16 and 24 hours]
- Need for rescue analgesia (meperidine) [Time frame: Postoperative 24 hours period]
- Adverse events [Time frame: Postoperative 24 hours period]
- Incidence and severity of Chronic Post-Thoracotomy Pain (CPTP) [Time frame: Incidence and severity of Chronic Post-Thoracotomy Pain (CPTP) at 3, 6, and 12 months post-surgery.]
Eligibility criteria
Inclusion criteria
- ASA physical status I-III.
- Scheduled for elective unilateral Video-Assisted Thoracoscopic Surgery (VATS).
Exclusion criteria
- History of allergy to local anesthetics.
- Pre-existing chronic pain syndrome or neuropathic pain.
- Psychiatric disorders affecting pain assessment.
- Coagulation disorders.
- Previous thoracic surgery on the same side.
Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.
Healthy volunteers: No
Study design
- Allocation
- Randomized
- Model
- Parallel assignment
- Masking
- Single blind
- Primary purpose
- Treatment
Study locations
Turkey (Türkiye) · 1 center
- Istanbul Medipol University Hospital — Istanbul
Publications
- Ciftci B, Alver S, Ahiskalioglu A, Bilal B, Tulgar S. Serratus posterior superior intercostal plane block: novel thoracic paraspinal block for thoracoscopic and shoulder surgery. Minerva Anestesiol. 2024 Apr;90(4):345-347. doi: 10.23736/S0375-9393.23.17827-8. Epub 2024 Jan 19. No abstract available. PMID 38240640
- Dogan G, Kucuk O, Kayir S, Dal GC, Ciftci B, Zengin M, Alagoz A. Serratus posterior superior intercostal plane block versus thoracic paravertebral block for pain management after video-assisted thoracoscopic surgery: a randomized prospective study. Braz J Anesthesiol. 2025 Sep-Oct;75(5):844647. doi: 10.1016/j.bjane.2025.844647. Epub 2025 Jun 3. PMID 40473018
- Cevikkalp E, Ulusoy E, Karakaya M, Ekinci M, Dikici M. Serratus posterior superior intercostal block as a component of multimodal analgesia in thoracotomy. Minerva Anestesiol. 2026 Mar;92(3):239-241. doi: 10.23736/S0375-9393.25.19490-X. Epub 2026 Jan 27. No abstract available. PMID 41591369
- Ozen V, Turan EI, Alver S, Sahin AS, Ciftci B. Combination of Fascial Plane Blocks Including Serratus Posterior Superior Intercostal Plane Block for Pediatric Thoracic Analgesia: Two Case Reports. A A Pract. 2026 Jan 14;20(1):e02144. doi: 10.1213/XAA.0000000000002144. eCollection 2026 Jan 1. PMID 41533022
Identifiers
NCT: NCT07436806 · Medipol Hospital 40