An interventional study of ESPB and SPSIPB in Postoperative Pain, sponsored by Saglik Bilimleri Universitesi Gazi Yasargil Training and Research Hospital. Recruiting at 2 sites in Turkey (Türkiye). Open to participants aged 18 Years to 85 Years. Per ClinicalTrials.gov, last updated 2026-09-21.
Sponsored by Saglik Bilimleri Universitesi Gazi Yasargil Training and Research Hospital · Not applicable, Interventional, and Treatment
Video-assisted thoracoscopic surgery (VATS) is associated with moderate to severe postoperative pain despite its minimally invasive nature. Ultrasound-guided erector spinae plane block (ESPB) and serratus posterior superior intercostal plane block (SPSIPB) are promising regional analgesic techniques for thoracic surgery; however, evidence directly comparing their effects on postoperative quality of recovery remains limited. This prospective, randomized, double-blind controlled trial aims to compare the effects of ESPB and SPSIPB on postoperative quality of recovery, measured by the Quality of Recovery-15 (QoR-15) questionnaire at 24 hours after surgery. Secondary outcomes include postoperative pain scores, tramadol consumption, time to first rescue analgesia, rescue analgesic requirement, postoperative nausea and vomiting, patient satisfaction, length of hospital stay, block-related complications, and perioperative hemodynamic parameters.
Video-assisted thoracoscopic surgery (VATS) has become the preferred surgical approach for many thoracic procedures because of its minimally invasive nature. Nevertheless, patients frequently experience moderate to severe postoperative pain, which may impair respiratory function, delay mobilization, prolong hospitalization, and negatively affect overall recovery. Effective multimodal analgesia is therefore essential for optimizing postoperative outcomes.
Ultrasound-guided erector spinae plane block (ESPB) and serratus posterior superior intercostal plane block (SPSIPB) are interfascial plane blocks that have demonstrated promising analgesic efficacy in thoracic surgery. Although both techniques are increasingly used in clinical practice, evidence directly comparing their effects on postoperative quality of recovery following VATS is limited.
This prospective, randomized, double-blind, parallel-group clinical trial will enroll 128 adult patients (18-70 years, ASA physical status I-III) undergoing elective VATS. Participants will be randomly assigned in a 1:1 ratio to receive either ultrasound-guided ESPB or ultrasound-guided SPSIPB before surgery.
The primary outcome is the Quality of Recovery-15 (QoR-15) score at 24 hours after surgery. Secondary outcomes include postoperative pain scores at rest and during coughing, cumulative 24-hour tramadol consumption, time to first rescue analgesia, rescue analgesic requirement, postoperative nausea and vomiting, sedation level, patient satisfaction, length of hospital stay, block-related complications, perioperative hemodynamic variables, and additional analgesic requirements.
The results of this study are expected to provide high-quality evidence regarding the comparative effectiveness of ESPB and SPSIPB in improving postoperative recovery and analgesic outcomes after VATS and may contribute to optimizing regional analgesia strategies for thoracic surgery.
5,640 studies on the registry are indexed under Pain, Postoperative; 1,230 are open to participants now.
This study's planned enrollment of 128 is above the median of 75 across 4,821 interventional studies indexed under Pain, Postoperative.
Browse Pain, Postoperative studies →Saglik Bilimleri Universitesi Gazi Yasargil Training and Research Hospital is the lead sponsor of 59 studies on the registry; 25 are open to participants now.
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Exclusion Criteria:
Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
The anaesthetists’ scale of health before surgery: I is healthy, II has a mild illness that is under control, III a severe one, IV a severe illness that is a constant threat to life. V and VI are used for the critically ill and for organ donors.
Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.
You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.
A reason a treatment, test or procedure should not be given to a particular person, such as an allergy, another illness or a medicine they take.
Weight in kilograms divided by height in metres squared. Example: 70 kg and 1.75 m gives 70 ÷ (1.75 × 1.75) ≈ 22.9.
What counts as overweight or obesity differs between countries (some use lower cut-offs), so go by the range the study states.
ASA physical status
The anaesthetists’ scale of health before surgery: I is healthy, II has a mild illness that is under control, III a severe one, IV a severe illness that is a constant threat to life. V and VI are used for the critically ill and for organ donors.
Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
Informed consent
Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.
You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.
Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
Contraindication
A reason a treatment, test or procedure should not be given to a particular person, such as an allergy, another illness or a medicine they take.
Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
BMI (body mass index)
Weight in kilograms divided by height in metres squared. Example: 70 kg and 1.75 m gives 70 ÷ (1.75 × 1.75) ≈ 22.9.
What counts as overweight or obesity differs between countries (some use lower cut-offs), so go by the range the study states.
Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
An ultrasound-guided erector spinae plane block (ESPB) will be performed before induction of general anesthesia using 30 mL of 0.25% bupivacaine for postoperative analgesia in patients undergoing elective video-assisted thoracoscopic surgery (VATS).
Procedure: ESPB
An ultrasound-guided serratus posterior superior intercostal plane block (SPSIPB) will be performed before induction of general anesthesia using 30 mL of 0.25% bupivacaine for postoperative analgesia in patients undergoing elective video-assisted thoracoscopic surgery (VATS).
Procedure: SPSIPB
An ultrasound-guided erector spinae plane block will be performed preoperatively for postoperative analgesia in patients undergoing elective video-assisted thoracoscopic surgery. The block will be performed using the standardized study protocol.
Also known as: Ultrasound-Guided Erector Spinae Plane Block
An ultrasound-guided serratus posterior superior intercostal plane block will be performed preoperatively for postoperative analgesia in patients undergoing elective video-assisted thoracoscopic surgery. The block will be performed using the standardized study protocol.
Also known as: Ultrasound-Guided Serratus Posterior Superior Intercostal Plane Block
Quality of Recovery-15 (QoR-15) Score
Postoperative quality of recovery will be assessed using the validated Turkish version of the Quality of Recovery-15 questionnaire. The total score ranges from 0 to 150, with higher scores indicating better recovery. The preoperative QoR-15 score will be recorded as a baseline measurement and considered in the analysis of the postoperative 24-hour score.
Time frame: 24 hours after surgery
Postoperative Pain at Rest
Postoperative pain intensity at rest will be assessed using an 11-point Numerical Rating Scale (NRS), with scores ranging from 0 (no pain) to 10 (worst imaginable pain).
Time frame: 30 minutes, 2 hours, 6 hours, 12 hours, and 24 hours after surgery.
Postoperative Pain Intensity During Coughing
Postoperative pain intensity during coughing will be assessed using an 11-point Numerical Rating Scale (NRS), with scores ranging from 0 (no pain) to 10 (worst imaginable pain).
Time frame: 30 minutes, 2 hours, 6 hours, 12 hours, and 24 hours after surgery.
Time to First Rescue Analgesia
The time from arrival in the post-anesthesia care unit (PACU) to the first administration of rescue analgesia will be recorded in minutes.
Time frame: During the first 24 hours after surgery
Cumulative Postoperative Tramadol Consumption
The total amount of tramadol administered for postoperative rescue analgesia during the first 24 hours after surgery will be recorded in milligrams (mg).
Time frame: During the first 24 hours after surgery
Requirement for Rescue Analgesia
The proportion of participants requiring at least one dose of rescue analgesia during the first 24 hours after surgery will be recorded.
Time frame: During the first 24 hours after surgery
Postoperative Nausea and Vomiting Impact Score
Postoperative nausea and vomiting will be assessed using the Simplified Postoperative Nausea and Vomiting Impact Scale. The scale combines the number of vomiting episodes and the perceived impact of nausea on recovery, with a total score ranging from 0 to 6. Higher scores indicate a greater impact of postoperative nausea and vomiting, and a score of 5 or greater indicates clinically important PONV.
Time frame: During the first 24 hours after surgery
Patient Satisfaction With Postoperative Analgesia
Patient satisfaction with postoperative pain management will be assessed using a 5-point Likert scale, where 1 = very dissatisfied, 2 = dissatisfied, 3 = neither satisfied nor dissatisfied, 4 = satisfied, and 5 = very satisfied. Higher scores indicate greater patient satisfaction.
Time frame: 24 hours after surgery
Postoperative Length of Hospital Stay
Postoperative length of hospital stay will be recorded as the number of days from surgery until hospital discharge.
Time frame: From surgery until hospital discharge (up to 30 days)
Incidence of Block-Related Complications
The incidence of block-related complications, including local anesthetic systemic toxicity, pneumothorax, hematoma, infection, vascular puncture, and other procedure-related adverse events, will be recorded.
Time frame: From block performance until hospital discharge (up to 30 days)
Plan to share: Undecided
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Saglik Bilimleri Universitesi Gazi Yasargil Training and Research Hospital