Serratus Posterior Superior Plane Block in Minimally Invasive Cardiac Surgery

Summary

This prospective randomized controlled trial aims to evaluate the effectiveness of the serratus posterior superior intercostal plane block (SPSIPB) as part of a multimodal analgesia strategy in patients undergoing minimally invasive cardiac surgery. Sixty adult ASA III patients scheduled for minimally invasive coronary artery bypass surgery will be randomly assigned to either an SPSIPB group or a control group receiving standard analgesic management without a plane block. The primary outcome is postoperative opioid (tramadol) consumption, while secondary outcomes include intraoperative remifentanil consumption, pain scores at rest and during coughing, time to first rescue analgesia, time to extubation, and lengths of intensive care unit and hospital stay. All patients will receive standardized general anesthesia and postoperative patient-controlled analgesia. Pain intensity will be assessed using the Numeric Rating Scale at predefined postoperative intervals. Postoperative complications such as nausea, vomiting, and atelectasis will be recorded. This study aims to determine whether SPSIPB provides effective opioid-sparing analgesia and improves postoperative recovery parameters in minimally invasive cardiac surgery.

Eligibility

Inclusion Criteria:

* Adults aged 18 years or older
* American Society of Anesthesiologists (ASA) physical status III
* Scheduled for elective minimally invasive coronary artery bypass surgery
* Ability to understand the study procedures and provide written informed consent

Exclusion Criteria:

* Age under 18 years
* ASA physical status other than III
* Pregnancy
* Emergency surgery
* History of trauma within the previous 24 hours
* Neurological disorders affecting consciousness or decision-making capacity
* Psychiatric disorders affecting decision-making capacity or cooperation
* Known allergy to local anesthetic agents
* Infection or skin disease at the block injection site
* Body mass index greater than 35 kg/m²
* Body weight less than 42 kg
* Coagulation disorders (international normalized ratio \>1.25, activated partial thromboplastin time \>35 seconds, or platelet count \<100,000/µL)

Conditions2

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