This study aims to evaluate the effectiveness of Serratus Posterior Superior Intercostal Plane (SPSIP) block compared to Intercostal Nerve (ICN) block in terms of postoperative pain control, reduction of opioid analgesic consumption, minimization of postoperative respiratory complications, and increase patient satisfaction (using a 5-point Likert scale) in patients undergoing video-assisted thoracoscopic surgery (VATS).
In this prospective observational study, patients included in the study will receive Serratus Posterior Superior Intercostal Plane (SPSIP) block and Intercostal Nerve (ICN) block for postoperative analgesia at the end of surgery. The SPSIP block will be performed by the anesthesiologist under ultrasound guidance immediately after skin closure and before extubation, while the ICN block will be performed by the surgeon under direct vision immediately before skin closure. At the end of surgery, patients will receive 1000 mg paracetamol and 50 mg dexketoprofen during skin closure. Upon arrival at the recovery room, each patient will be connected to a patient-controlled analgesia (PCA) pump containing tramadol. At postoperative reassessment, patients with a Numerical Pain Rating Scale (NPRS) score greater than 4 despite PCA use will receive a rescue analgesic dose of 50 mg dexketoprofen. Postoperative pain intensity will be assessed using the NPRS (Numerical Pain Rating Scale) at 1, 4, 6, 12, 18, and 24 hours postoperatively, both at rest and during coughing. Total opioid consumption, rescue analgesic use, and postoperative complications will be recorded. Patients will be informed about their level of surgical satisfaction 24 hours after surgery, and this information will be recorded.
Study Type
OBSERVATIONAL
Enrollment
82
Kocaeli City Hospital
İzmit, Turkey (Türkiye)
Postoperative pain intensity
In both study groups, postoperative pain intensity at rest and with coughing was measured using the Numerical Pain Rating Scale (NPRS), a numerical scale ranging from 0 to 10 (0 meaning no pain, 10 meaning the most severe pain imaginable).
Time frame: 24 hours after the end of surgery
Total opioid drug consumption
The total amount of opioid doses administered via a Patient Controlled Analgesia (PCA) device in the first 24 hours after surgery
Time frame: 24 hours after the end of surgery
Consumption of rescue analgesics
The total dose of dexketoprofen required by the patient during each specified time interval in the first 24 hours after surgery.
Time frame: 24 hours after the end of surgery
Postoperative Complications
Postoperative complications such as nausea, vomiting or other adverse events will be recorded
Time frame: 24 hours after the end of surgery
Patient satisfaction score
evaluated using a 5-point Likert scale (1=very dissatisfied, 5=very satisfied)
Time frame: At the 24th hour post-operation
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