Serratus Posterior Superior Intercostal Plane Block for Analgesia in Off-Pump Minimally Invasive CABG

Recruiting now · Not applicable

Conditions studied: Postoperative Pain, Postoperative Analgesia

In brief

Postoperative pain after cardiac surgery is commonly moderate to severe due to sternotomy, thoracotomy, internal mammary artery harvesting, and chest tube placement, and may contribute to adverse systemic and pulmonary outcomes if inadequately managed. Enhanced Recovery After Surgery (ERAS) protocols emphasize opioid-sparing strategies to reduce opioid-related side effects and complications. Ultrasound-guided fascial plane blocks have increasingly been incorporated into perioperative analgesia protocols for cardiac surgery. The serratus posterior superior intercostal plane block (SPSIPB), a recently described technique, provides wide dermatomal sensory coverage and may offer effective analgesia in thoracic and cardiac surgical procedures. This prospective, randomized controlled study aims to evaluate the analgesic efficacy of SPSIPB in adult patients undergoing off-pump minimally invasive coronary artery bypass grafting (CABG). A total of 60 ASA III patients aged 18 years or older will be randomized into two groups: SPSIPB group and control group. The SPSIPB will be performed preoperatively under ultrasound guidance using 0.25% bupivacaine, while the control group will receive standard general anesthesia without any plane block. All patients will receive standardized general anesthesia and postoperative patient-controlled analgesia with tramadol. The primary outcome of the study is postoperative recovery quality assessed using the Quality of Recovery-15 (QoR-15) questionnaire. Secondary outcomes include intraoperative remifentanil consumption, postoperative opioid requirements, time to first rescue analgesia, numerical rating scale (NRS) pain scores at rest and during coughing, extubation time, intensive care unit and hospital length of stay, and postoperative complications such as nausea, vomiting, and atelectasis. This study aims to determine whether SPSIPB can improve postoperative recovery quality and reduce opioid consumption in patients undergoing off-pump minimally invasive CABG.

Key facts

Study ID: NCT07412522
Run by: Kartal Kosuyolu High Speciality Training and Research Hospital
People needed: 60
Starts: 2025-09-01
Expected to finish: 2026-09-01
Last updated by the study team: 2026-02-17

Who can join

Age: 18 and older, up to 75. Sex: any. Healthy volunteers: accepted.

You may qualify if…

Patients aged 18-75 years
ASA physical status II-III
Scheduled for elective off-pump minimally invasive coronary artery bypass grafting (CABG) surgery
Ability to understand and use the Numerical Rating Scale (NRS)
Ability to provide written informed consent

You may not qualify if…

Refusal to participate in the study
Known allergy or contraindication to local anesthetics
Coagulation disorders or ongoing anticoagulant therapy incompatible with regional anesthesia
Infection at the block injection site
Severe hepatic or renal dysfunction
Chronic opioid use or opioid dependence
History of chronic pain syndromes
Severe pulmonary disease (e.g., advanced COPD)
Neurological or psychiatric disorders that may interfere with pain assessment
Emergency surgery
Conversion to on-pump CABG or sternotomy during surgery

Where it is running

Kosuyolu High Specialization Training and Research Hospital — Istanbul, Turkey (Türkiye) (enrolling)

Full record on ClinicalTrials.gov

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