Comparison of the Rhomboid Intercostal Block and Serratus Posterior Superior Intercostal Plane Block

Ankara City Hospital Bilkent90 enrolled

Overview

Video-assisted thoracic surgery (VATS) is widely performed for the management of various thoracic pathologies and is generally associated with reduced surgical trauma compared with open thoracotomy. Nevertheless, patients may still experience considerable postoperative pain, which can adversely affect respiratory function, mobilization, and recovery. Various regional analgesic techniques have been incorporated into multimodal pain management strategies for VATS, including thoracic paravertebral block (TPVB), erector spinae plane block (ESPB), intercostal nerve block, serratus anterior plane block (SAPB), rhomboid intercostal block (RIB), and serratus posterior superior intercostal plane block (SPSIPB). Among these approaches, ultrasound-guided TPVB has traditionally been regarded as a reference regional analgesic technique. More recently, interfascial plane blocks have gained increasing attention because of their technical simplicity and favorable safety profile. RIB and SPSIPB are two novel interfascial plane blocks that may provide effective postoperative analgesia following thoracic surgery. The present study aims to compare the analgesic efficacy of RIB and SPSIPB in patients undergoing VATS and to evaluate their impact on postoperative pain outcomes.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

DOUBLE

Enrollment

Conditions

Pain, Postoperative Multimodal Analgesia

Eligibility

Sex: ALLMin age: 18 YearsMax age: 75 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Patients undergoing elective VATS * Patients aged 18-75 years * Patients with ASA (American Society of Anesthesiologists) class I-III * Patients who have given informed consent Exclusion Criteria: * Patients allergic to local anesthetics * Patients with bleeding disorders or those undergoing anticoagulant therapy * Pregnant and breastfeeding women * Patients with impaired consciousness, inability to communicate, or mental/cognitive impairment * Patients who refuse block application * Patients with infection in the area where the block will be applied

Outcomes

Primary Outcomes

Surgical Pain Scores

Surgical pain will be assessed at rest and while coughing using the visual analog scale on a scale from 0mm (no pain) to 100mm (worst pain). Pain assessment will be done at 1st, 6th, 12th, and 24th hours after surgery.

Time frame: 24 hours after surgery

Secondary Outcomes

Shoulder Pain Scores

Shoulder pain will be assessed at rest and while coughing using the visual analog scale on a scale from 0mm (no pain) to 100mm (worst pain). Pain assessment will be done at 1st, 6th, 12th, and 24th hours after surgery.

Time frame: 24 hours after surgery

Intraoperative remifentanil consumption

The amount of remifentanil that patients need to maintain anesthesia during the intraoperative period will be recorded.

Time frame: During the intraoperative period