Comparison of Deep Serratus Anterior Plane Block and Combination of Deep and Superficial Serratus Anterior Plane Block

NCT ID: NCT05106283

Last Updated: 2022-08-25

Basic Information

• Recruitment Status: COMPLETED
• Clinical Phase: NA
• Total Enrollment: 60 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2021-10-22
• Study Completion Date: 2022-08-23

Brief Summary

Video-assisted thoracic surgery (VATS) has become a common procedure in thoracic surgery. Severe postoperative pain may be encountered in patients undergoing VATS. Analgesic methods such as thoracic paravertebral block (TPVB), intercostal block, serratus anterior plane block (SAPB) and erector spina plane block (ESPB) are widely used for VATS. Among these methods, ultrasound (US) guided TPVB is the most preferred method. In recent years, the frequency of application of plane blocks as a component of multimodal analgesia has been increased. ESPB and SAPB are some of them. There are two techniques for SAPB application. In Deep SAPB (DSAPB) application, local anesthetic agent is given under the serratus anterior muscle. In the Superficial SAPB (SSAPB) application, the local anesthetic agent is given above the serratus anterior muscle. Since it is done by entering from the same point in two applications, it is possible to perform these two applications at the same time with a single needle entry. The mechanisms of regional analgesia techniques used after thoracic surgery operations are also different from each other. Therefore, it may be possible to obtain a more effective analgesic effect in patients by combining the mechanism of action of DSAPB and SSAPB , as in the multimodal analgesia method. This study seeks to evaluate the effect of DSAPB and combined DSAPB-SSAPB pain after VATS.

Conditions

Pain, Postoperative; Serratus Anterior Plane Block; Multimodal Analgesia; Thoracic Surgery, Video-Assisted

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: PARALLEL
• Primary Study Purpose: TREATMENT
• Blinding Strategy: DOUBLE

Study Groups

Deep Serratus Anterior Plane Block

Following the visualization of the anatomical structures, the nerve block needle will be advanced via the in-plane technique beneath the serratus anterior muscles until the interfascial space was reached. After hydrodissection with 2 ml normal saline, 20 ml 0.25% bupivacaine will be injected into the area.

Group Type: ACTIVE_COMPARATOR

Deep block and Combined Block

Intervention Type: PROCEDURE

Deep serratus anterior block and combined deep and superficial serratus anterior plane block will be applied to the patients under real-time ultrasound guidance.

Deep and Superficial Serratus Anterior Plane Block

In patients who are planned to have combined deep and superficial serratus anterior plane block, following the visualization of the anatomical structures, the nerve block needle will be advanced via the in-plane technique beneath the serratus anterior muscles until the interfascial space was reached. After hydrodissection with 2 ml normal saline, 10 ml 0.25% bupivacaine will be injected into the area. Then, with the same needle, will be returned 1-2 cm from the deep serratus anteror area to superficial serratus anteror area above the serratus anterior muscle and will be injected 2 ml normal saline for hydrodissection. Finally 10 ml of 0.25% bupivacaine will be injected for superficial serratus anetrior block into the interfacial area.

Group Type: ACTIVE_COMPARATOR

Deep block and Combined Block

Intervention Type: PROCEDURE

Deep serratus anterior block and combined deep and superficial serratus anterior plane block will be applied to the patients under real-time ultrasound guidance.

Interventions

Deep block and Combined Block

Deep serratus anterior block and combined deep and superficial serratus anterior plane block will be applied to the patients under real-time ultrasound guidance.

Intervention Type: PROCEDURE

Eligibility Criteria

Inclusion Criteria

• 18 to 65 years old
• ASA physical status I-II-III
• BMI 18 to 30 kg/m2
• Elective video assisted thoracoscopic surgery

Exclusion Criteria

• Patient refusing the procedure
• Emergency surgery
• Chronic opioid or analgesic use

• Minimum Eligible Age: 18 Years
• Maximum Eligible Age: 65 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Atatürk Chest Diseases and Chest Surgery Training and Research Hospital

OTHER

Sponsor Role: lead

Responsible Party

Musa Zengin

Principal İnvestigator

Responsibility Role: PRINCIPAL_INVESTIGATOR

Principal Investigators

Musa Zengin, MD

Role: PRINCIPAL_INVESTIGATOR

Atatürk Chest Diseases and Chest Surgery Training and Research Hospital

Locations

Ankara Atatürk Chest Disease and Chest Surgery Training and Research Hospital

Keçiören, Ankara, Turkey (Türkiye)

Countries

Turkey (Türkiye)

Other Identifiers

E.Kurul-E1-21-2066

Identifier Type: -

Identifier Source: org_study_id