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Not yet recruiting NCT07729488

ESPB Versus SPSIPB for Quality of Recovery After Video-Assisted Thoracoscopic Surgery

No phase Interventional Postoperative Pain

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: ESPB, SPSIPB.
Who it may be relevant to
Registry conditions: Postoperative Pain. Basic parameters: 18 years — 85 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

Comparison of Ultrasound-Guided Erector Spinae Plane Block and Serratus Posterior Superior Intercostal Plane Block for Quality of Recovery After Video-Assisted Thoracoscopic Surgery: A Randomized Double-Blind Trial

Overview

Video-assisted thoracoscopic surgery (VATS) is associated with moderate to severe postoperative pain despite its minimally invasive nature. Ultrasound-guided erector spinae plane block (ESPB) and serratus posterior superior intercostal plane block (SPSIPB) are promising regional analgesic techniques for thoracic surgery; however, evidence directly comparing their effects on postoperative quality of recovery remains limited. This prospective, randomized, double-blind controlled trial aims to compare the effects of ESPB and SPSIPB on postoperative quality of recovery, measured by the Quality of Recovery-15 (QoR-15) questionnaire at 24 hours after surgery. Secondary outcomes include postoperative pain scores, tramadol consumption, time to first rescue analgesia, rescue analgesic requirement, postoperative nausea and vomiting, patient satisfaction, length of hospital stay, block-related complications, and perioperative hemodynamic parameters.

Detailed description

Video-assisted thoracoscopic surgery (VATS) has become the preferred surgical approach for many thoracic procedures because of its minimally invasive nature. Nevertheless, patients frequently experience moderate to severe postoperative pain, which may impair respiratory function, delay mobilization, prolong hospitalization, and negatively affect overall recovery. Effective multimodal analgesia is therefore essential for optimizing postoperative outcomes.

Ultrasound-guided erector spinae plane block (ESPB) and serratus posterior superior intercostal plane block (SPSIPB) are interfascial plane blocks that have demonstrated promising analgesic efficacy in thoracic surgery. Although both techniques are increasingly used in clinical practice, evidence directly comparing their effects on postoperative quality of recovery following VATS is limited.

This prospective, randomized, double-blind, parallel-group clinical trial will enroll 128 adult patients (18-70 years, ASA physical status I-III) undergoing elective VATS. Participants will be randomly assigned in a 1:1 ratio to receive either ultrasound-guided ESPB or ultrasound-guided SPSIPB before surgery.

The primary outcome is the Quality of Recovery-15 (QoR-15) score at 24 hours after surgery. Secondary outcomes include postoperative pain scores at rest and during coughing, cumulative 24-hour tramadol consumption, time to first rescue analgesia, rescue analgesic requirement, postoperative nausea and vomiting, sedation level, patient satisfaction, length of hospital stay, block-related complications, perioperative hemodynamic variables, and additional analgesic requirements.

The results of this study are expected to provide high-quality evidence regarding the comparative effectiveness of ESPB and SPSIPB in improving postoperative recovery and analgesic outcomes after VATS and may contribute to optimizing regional analgesia strategies for thoracic surgery.

Interventions

  • Procedure ESPB
    An ultrasound-guided erector spinae plane block will be performed preoperatively for postoperative analgesia in patients undergoing elective video-assisted thoracoscopic surgery. The block will be performed using the standardized study protocol.
  • Procedure SPSIPB
    An ultrasound-guided serratus posterior superior intercostal plane block will be performed preoperatively for postoperative analgesia in patients undergoing elective video-assisted thoracoscopic surgery. The block will be performed using the standardized study protocol.

Primary outcome measures

  • Quality of Recovery-15 (QoR-15) Score [Time frame: 24 hours after surgery]
Secondary outcome measures (9)
  • Postoperative Pain at Rest [Time frame: 30 minutes, 2 hours, 6 hours, 12 hours, and 24 hours after surgery.]
  • Postoperative Pain Intensity During Coughing [Time frame: 30 minutes, 2 hours, 6 hours, 12 hours, and 24 hours after surgery.]
  • Time to First Rescue Analgesia [Time frame: During the first 24 hours after surgery]
  • Cumulative Postoperative Tramadol Consumption [Time frame: During the first 24 hours after surgery]
  • Requirement for Rescue Analgesia [Time frame: During the first 24 hours after surgery]
  • Postoperative Nausea and Vomiting Impact Score [Time frame: During the first 24 hours after surgery]
  • Patient Satisfaction With Postoperative Analgesia [Time frame: 24 hours after surgery]
  • Postoperative Length of Hospital Stay [Time frame: From surgery until hospital discharge (up to 30 days)]
  • Incidence of Block-Related Complications [Time frame: From block performance until hospital discharge (up to 30 days)]

Eligibility criteria

Inclusion criteria

  • Adults aged 18-85 years.
  • ASA physical status I-III.
  • Scheduled for elective VATS under general anesthesia.
  • Able to understand and complete the QoR-15 questionnaire.
  • Written informed consent provided.

Exclusion criteria

  • Refusal to participate or inability to provide written informed consent.
  • Known allergy or contraindication to bupivacaine, paracetamol, dexketoprofen, or tramadol.
  • Infection at the planned block injection site.
  • Coagulopathy or ongoing anticoagulant therapy precluding regional anesthesia.
  • Severe hepatic or renal insufficiency.
  • Chronic opioid use or chronic pain requiring regular analgesic treatment.
  • Previous thoracic surgery on the operative side.
  • Pregnancy or breastfeeding.
  • Cognitive impairment, psychiatric illness, or language barrier preventing completion of the QoR-15 questionnaire.
  • Body mass index (BMI) >35 kg/m².
  • Conversion from VATS to thoracotomy.
  • Failed or incomplete regional block.

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
Double blind
Primary purpose
Treatment

Study locations

Turkey (Türkiye) · 2 centers
  • Fatma Acil — Diyarbakır
  • Saglik Bilimleri Universitesi Gazi Yasargil Training and Research Hospital — Diyarbakır

Identifiers

NCT: NCT07729488 · 07/20/2026-xxx

Primary sources (government registries)

View this study on ClinicalTrials.gov ↗