Comparison of Superficial+Deep Vs. Deep Serratus Anterior Plan Block in Video-Assisted Thoracic Surgery

Study Overview
=================
Brief Summary
-----------------
Thoracotomy is one of the most painful surgeries; Video-assisted thoracoscopic surgery (VATS) has been developed to reduce the surgical stress of thoracotomy. However, patients may experience moderate to severe pain within the first 24 hours after VATS. Intravenous opioids are frequently used to provide postoperative analgesia, and accordingly, side effects such as postoperative nausea/vomiting and respiratory depression can be seen. The aim of this study is to compare Superficial+Deep Vs. Deep Serratus Anterior Plan Block for postoperative pain control in VATS cases.

Official Title
-----------------
Comparison of Combined Superficial and Deep Serratus Anterior Plan Block Versus Deep Serratus Anterior Plan Block for Postoperative Pain Control in Video-Assisted Thoracic Surgery

Conditions
-----------------
Analgesia

Intervention / Treatment
-----------------
* Other: Group Superficial+Deep Serratus Anterior Plan Block
* Other: Group Deep Serratus Anterior Plan Block


Participation Criteria
=================
Eligibility Criteria
-----------------
Inclusion Criteria: American Society of Anesthesiologist's physiologic state I-III patients To undergo Video Assisted Thoracic Surgery Being between the ages of 18-65 years Exclusion Criteria: having a known heart, kidney, liver or hematological disease having a history of peptic ulcer, gastrointestinal bleeding, allergy, chronic pain Routine analgesic use and history of analgesic use in the last 24 hours Not willingto participate in the study Uncooperative patients who have coagulopathy or use anticoagulant drugs To be allergic to one of the drugs to be used Contraindication for Video Assisted Thoracic Surgery

Ages Eligible for Study
-----------------
Minimum Age: 18 Years
Maximum Age: 65 Years

Sexes Eligible for Study
-----------------
All

Accepts Healthy Volunteers
-----------------
No

Study Plan
=================
How is the study designed?
-----------------

Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Triple


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: Group Superficial+Deep Serratus Anterior Plan Block<br>Superficial+Deep Serratus Anterior Plan Block after Video-Assisted Thoracic Surgery | Other: Group Superficial+Deep Serratus Anterior Plan Block<br>* The block will be performed after induction of general anesthesia and surgical positioning. 15 ml of 0.375% Bupivacaine + epinephrine 5 µg/ml will be administered between the serratus anterior and latissimus dorsalis muscles. The same concentration of block fluid will be applied between the serratus anterior and the outer intercostal muscle.<br>|
| Active Comparator: Group Deep Serratus Anterior Plan Block<br>Deep Serratus Anterior Plan Block after Video-Assisted Thoracic Surgery | Other: Group Deep Serratus Anterior Plan Block<br>* 30 ml 0.375% Bupivacaine + epinephrine 5 µg/ml will be administered between the serratus anterior and outer intercostal muscle.<br>|

What is the study measuring?
-----------------
Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Postoperative opioid consumption | First 24 hours total fentanyl consumption with patient controlled analgesia | first 24 hours | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Visual analog pain score | Post operative pain will be evaluated with a Visual Analogue Scale (between 0-10; 0: no pain, 10:worst pain) score | first 48 hours |