SPSIP Block and Opioid Use After MICS

Summary

This prospective, randomized, controlled, single-center clinical study aims to evaluate the effectiveness of the Serratus Posterior Superior Intercostal Plane Block (SPSIPB) in perioperative pain management among patients undergoing minimally invasive cardiac surgery (MICS). A total of 50 patients undergoing MICS will be randomized into two groups: one receiving standard analgesia plus ultrasound-guided SPSIPB with 30 mL of 0.25% bupivacaine, and a control group receiving standard analgesia only. The primary outcome is total postoperative opioid consumption within 24 hours. Secondary outcomes include postoperative pain scores, extubation time, block-related complications, and recovery parameters such as early mobilization, oral intake, Modified radiological atelectasis score and Quality of Recovery-15 scores.

Eligibility

Inclusion Criteria:

* Patients scheduled for minimally invasive cardiac surgery (MICS)
* Age between 18 and 75 years
* American Society of Anesthesiologists (ASA) physical status II-III
* Body mass index (BMI) between 18 and 35 kg/m²
* Patients who provide written informed consent for participation

Exclusion Criteria:

* Known allergy or hypersensitivity to local anesthetics
* Coagulopathy or current anticoagulant therapy
* Pregnancy or breastfeeding
* Impaired consciousness or inability to communicate
* Failed or technically inadequate block
* Refusal to undergo the block procedure
* Cognitive or mental disorders preventing valid pain assessment
* Opioid intolerance or contraindication to opioid use
* Development of intraoperative or postoperative complications requiring reoperation, prolonged mechanical ventilation, or intensive care
* Incomplete postoperative data or patient withdrawal from the study

Conditions5

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