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Not yet recruitingNCT07739407PACE-PECSUpdated Jul 31, 2026

Ultrasound-Guided PECS II Block for Permanent Pacemaker Implantation

An interventional study of Ultrasound-Guided PECS II Block and Standard Local Infiltration Anesthesia in Cardiac Pacing, Permanent Pacemaker Implantation and Postoperative Pain, sponsored by ferdi gülaştı. Not yet recruiting. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2026-07-31.

Sponsored by ferdi gülaştı · Not applicable, Interventional, and Treatment

Phase
Not applicable
Study type
Interventional
Enrollment
72
Allocation
Randomized
Ages
18 Years and older
Sex
All
01

Study summary

This single-center, prospective, randomized, controlled clinical trial aims to evaluate whether ultrasound-guided PECS II block, when added to standard local infiltration anesthesia, improves perioperative analgesia in patients undergoing elective permanent pacemaker implantation.

Seventy-two adult patients scheduled for elective permanent pacemaker implantation will be randomly assigned in a 1:1 ratio to receive either ultrasound-guided PECS II block plus standard local infiltration anesthesia or standard local infiltration anesthesia alone. The primary outcome is pain intensity during pacemaker pocket creation measured using the Numerical Rating Scale (NRS). Secondary outcomes include intraoperative pain scores, additional local anesthetic, opioid and sedative requirements, postoperative pain scores, analgesic consumption during the first 24 hours, patient and operator satisfaction, procedure duration, and procedure-related complications. The study is designed to determine whether PECS II block provides additional analgesic benefit during permanent pacemaker implantation.

Read the detailed description

Permanent pacemaker implantation is commonly performed under local infiltration anesthesia; however, patients may still experience significant pain during skin incision, pocket creation, and generator placement, frequently requiring supplemental local anesthetics, opioids, or sedatives. Ultrasound-guided PECS II block has recently emerged as a promising regional anesthesia technique for cardiac implantable electronic device procedures by providing sensory blockade of the anterior chest wall.

This investigator-initiated, single-center, prospective, parallel-group, randomized controlled trial will compare ultrasound-guided PECS II block combined with standard local infiltration anesthesia with standard local infiltration anesthesia alone in patients undergoing elective permanent pacemaker implantation.

A total of 72 adult patients will be randomized in a 1:1 ratio into two treatment groups. Patients assigned to the intervention group will receive an ultrasound-guided PECS II block with 20 mL of 0.25% bupivacaine before the procedure, followed by standard local infiltration anesthesia. Patients in the control group will receive standard local infiltration anesthesia alone. Rescue analgesia and light sedation will be administered only when clinically required according to a predefined protocol.

The primary endpoint is the Numerical Rating Scale (NRS, 0-10) pain score during pacemaker pocket creation. Secondary endpoints include the highest intraoperative pain score, pain scores at different procedural stages and during the first 24 postoperative hours, total intraoperative local anesthetic consumption, additional opioid and sedative requirements, postoperative analgesic consumption, patient and operator satisfaction, procedure duration, block performance time, and procedure-related complications.

The study is expected to provide evidence regarding the effectiveness of ultrasound-guided PECS II block as an adjunct to standard local infiltration anesthesia for improving perioperative pain control and reducing additional analgesic requirements during elective permanent pacemaker implantation

02

Conditions studied

  • Cardiac Pacing
  • Permanent Pacemaker Implantation
  • Postoperative Pain

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Keywords

  • PECS II Block
  • Permanent Pacemaker
  • Local Infiltration Anesthesia
  • Perioperative Analgesia
  • Randomized Controlled Trial
03

In context

Pain, Postoperative

5,093 studies on the registry are indexed under Pain, Postoperative; 1,140 are open to participants now.

This study's planned enrollment of 72 is close to the median of 75 across 4,344 interventional studies indexed under Pain, Postoperative.

Browse Pain, Postoperative studies →

Lead sponsor

This is the only study on the registry with ferdi gülaştı as lead sponsor.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  • Age 18 years or older.
  • Scheduled for elective permanent pacemaker implantation.
  • American Society of Anesthesiologists (ASA) physical status I-III.
  • Ability to understand the study procedures and provide written informed consent.

Exclusion criteria

Exclusion Criteria:

  • Infection at the planned block site.
  • Known allergy or hypersensitivity to local anesthetics.
  • Uncorrected coagulopathy or active bleeding disorder.
  • Contraindication to PECS II block because of anticoagulant or antiplatelet therapy.
  • Severe cognitive impairment or inability to use the Numerical Rating Scale (NRS).
  • Emergency pacemaker implantation.
  • Planned generator replacement, lead revision, or device revision procedure.
  • Anatomical abnormalities preventing safe block performance.
  • Refusal to participate in the study.
05

Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Single (Outcomes assessor)
Enrollment
72 participants (estimated)

Study arms

  • Experimental
    PECS II Block + Standard Local Infiltration

    Participants will receive an ultrasound-guided PECS II block with 20 mL of 0.25% bupivacaine before the procedure, followed by standard local infiltration anesthesia with 1% lidocaine during elective permanent pacemaker implantatio

    Other: Ultrasound-Guided PECS II Block · Other: Standard Local Infiltration Anesthesia

  • Active comparator
    Standard Local Infiltration

    Participants will receive standard local infiltration anesthesia with 1% lidocaine during elective permanent pacemaker implantation without PECS II block.

    Other: Standard Local Infiltration Anesthesia

Interventions

  • OtherUltrasound-Guided PECS II Block

    Ultrasound-guided PECS II block will be performed before permanent pacemaker implantation using 20 mL of 0.25% bupivacaine. The local anesthetic will be injected between the pectoralis major and pectoralis minor muscles and between the pectoralis minor and serratus anterior muscles under ultrasound guidance.

  • OtherStandard Local Infiltration Anesthesia

    Standard local infiltration anesthesia will be administered by the implanting physician using 1% lidocaine at the incision site and pacemaker pocket according to routine clinical practice.

06

What researchers measure

Primary outcomes

  1. Pain intensity during pacemaker pocket creation measured by the Numerical Rating Scale (NRS, 0-10)

    Pain intensity will be assessed using an 11-point Numerical Rating Scale (NRS), where 0 indicates no pain and 10 indicates the worst imaginable pain. The primary endpoint is the NRS pain score recorded during pacemaker pocket creation.

    Time frame: During pacemaker pocket creation (intraoperative assessment)

07

Study locations

No study locations are listed for this record.

08

References and documents

Publications

  • Kilin M, Kavakli AS, Karaveli A, Sugur T, Kus G, Cagirci G, Arslan S. PECS II block for cardiac implantable electronic device insertion: A pilot study. Pacing Clin Electrophysiol. 2023 Oct;46(10):1251-1257. doi: 10.1111/pace.14811. Epub 2023 Sep 4. PubMed 37665000 ↗

Individual participant data

Plan to share: Undecided

09

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Jul 31, 2026, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT07739407
Lead sponsor
ferdi gülaştı
Responsible party
ferdi gülaştı (Aydin Adnan Menderes University Faculty of Medicine, Aydin Adnan Menderes University) — Sponsor-investigator
First posted
Jul 31, 2026
Start date
Aug 5, 2026 (estimated)
Primary completion
Aug 5, 2027 (estimated)
Completion
Aug 5, 2027 (estimated)
Last update
Jul 31, 2026

Study contacts

Ferdi Gulasti, MD
Contact
ferdigulasti@gmail.com
+905054929650
SEVİL GÜLAŞTI, MD
Contact
drsevilonay@hotmail.com
Ferdi Gulasti
principal investigator · Aydın Adnan Menderes University Hospital

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

Not currently enrolling

This study is not yet recruiting, as verified in Jul 2026. You cannot join it, but the record below documents what was studied.

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