Clinical trial NCT07011069: Rhomboid Intercostal and Subserratus Plane Block vs Erector Spinae Plane Block in Video-Assisted Thoracoscopic Surgery
Official title: Comparison of the Efficacy of Rhomboid Intercostal and Subserratus Plane Block (RISS) Versus Erector Spinae Plane (ESP) Blocks in Video-Assisted Thoracoscopic Surgery (VATS) for Postoperative Pain Management and Respiratory Function
Study type: INTERVENTIONAL
Overall status: RECRUITING
Phase: NA
Conditions: Video Assisted Thoracoscopic Surgery
Regional Block for Pain Control
Regional Blocks
Pulmonary Functions
Lead sponsor: Bursa City Hospital
Sponsor class: OTHER_GOV
First posted: 2025-06-08
Enrollment: 90
Sex: ALL
Minimum age (years): 18
Maximum age (years): 80
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: TREATMENT

Brief summary: To compare the rhomboid intercostal subserratus plane block with the erector spinae plane block regarding their analgesic efficacy and effects on respiratory function for patients undergoing video-assisted thoracoscopic surgery.

Detailed description: Video-assisted thoracoscopic surgery (VATS) can be very painful and may lead to complications such as prolonged stays in intensive care, thromboembolic complications due to lack of early mobilization, chronic acute pain, and delirium if adequate analgesia is not provided. Therefore, using thoracic epidural, paravertebral, or regional blocks as part of multimodal analgesia is recommended to provide effective pain relief.

This study aims to compare the effects of the erector spinae plane block (ESP) and rhomboid intercostal subserratus plane block (RISS) on postoperative analgesia and the improvement of respiratory parameters in patients undergoing VATS.

The primary objective is to evaluate total analgesic consumption in the first 24 hours postoperatively. Secondary objectives include assessing active and dynamic pain scores, triflow performance, complications, and the length of hospital stays.

Eligibility criteria: Inclusion Criteria:

* Patients who will undergo VATS
* Who agrees to participate
* American Society of Anesthesiologists (ASA) physical status I, II, and III
* Elective surgery
* Age between 18 and 80 years

Exclusion Criteria:

* Local anesthetic allergy
* Who disagrees to participate
* ASA physical status IV and V
* Emergency surgery
* Hemorrhagic disease
* Thoracic vertebrae deformity
* Thoracic vertebrae surgery

Primary outcomes:
measure: Opioid consumption
timeFrame: Postoperative first 24 hours.
Secondary outcomes:
measure: Dynamic pain score
timeFrame: Postoperative first 24 hours.
measure: Resting pain score
timeFrame: Postoperative first 24 hours.
measure: Pulmonary functions
timeFrame: Postoperative first 24 hours.
measure: Complications
timeFrame: Through study completion, an average of 1 year
measure: Hospital stay time
timeFrame: Perioperatively
Other outcomes:
Locations:
city: Bursa
country: Turkey
facility: University of Health Sciences, Bursa City Hospital
state: Nilufer
Study officials:
References:
citation: Forero M, Rajarathinam M, Adhikary S, Chin KJ. Erector spinae plane (ESP) block in the management of post thoracotomy pain syndrome: A case series. Scand J Pain. 2017 Oct;17:325-329. doi: 10.1016/j.sjpain.2017.08.013. Epub 2017 Sep 12.
citation: Elsharkawy H, Maniker R, Bolash R, Kalasbail P, Drake RL, Elkassabany N. Rhomboid Intercostal and Subserratus Plane Block: A Cadaveric and Clinical Evaluation. Reg Anesth Pain Med. 2018 Oct;43(7):745-751. doi: 10.1097/AAP.0000000000000824.
citation: Hsieh MJ, Wang KC, Liu HP, Gonzalez-Rivas D, Wu CY, Liu YH, Wu YC, Chao YK, Wu CF. Management of acute postoperative pain with continuous intercostal nerve block after single port video-assisted thoracoscopic anatomic resection. J Thorac Dis. 2016 Dec;8(12):3563-3571. doi: 10.21037/jtd.2016.12.30.