An interventional study of Rhomboid Intercostal Block and Serratus Posterior Superior Intercostal Plane Block in Pain, Postoperative, Multimodal Analgesia and Rhomboid Intercostal Block, sponsored by Ankara City Hospital Bilkent. Recruiting at 1 site in Turkey (Türkiye). Open to participants aged 18 Years to 75 Years. Per ClinicalTrials.gov, last updated 2026-06-16.
Sponsored by Ankara City Hospital Bilkent · Not applicable, Interventional, and Treatment
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.
5,093 studies on the registry are indexed under Pain, Postoperative; 1,140 are open to participants now.
This study's planned enrollment of 90 is above the median of 75 across 4,344 interventional studies indexed under Pain, Postoperative.
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Exclusion Criteria:
For patients scheduled to receive a Rhomboid Intercostal Block (RIB), after sonographic identification of the relevant anatomical structures, the block needle is advanced using an in-plane ultrasound-guided technique beneath the rhomboid muscle until contact with the rib is achieved. Following hydrodissection with 2 mL of normal saline to confirm correct needle placement, 30 mL of 0.25% bupivacaine is injected into the interfascial plane.
Drug: Rhomboid Intercostal Block
For patients scheduled to receive a Serratus Posterior Superior Intercostal Plane Block (SPSIPB), after sonographic identification of the relevant anatomical structures, the block needle is advanced using an in-plane ultrasound-guided technique beneath the serratus posterior superior muscle until contact with the rib is achieved. Following hydrodissection with 2 mL of normal saline to confirm correct needle placement, 30 mL of 0.25% bupivacaine is injected into the interfascial plane.
Drug: Serratus Posterior Superior Intercostal Plane Block
Rhomboid intercostal block will be applied to the patients under real-time ultrasound guidance.
Serratus posterior superior intercostal plane block will be applied to the patients under real-time ultrasound guidance.
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
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
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Ankara City Hospital Bilkent