This prospective observational study aims to compare the postoperative analgesic effectiveness of three commonly used pain management strategies in video-assisted thoracoscopic surgery (VATS): Serratus Posterior Superior Intercostal Plane Block (SPSIPB), Thoracic Epidural Analgesia (TEA), and systemic opioid analgesia. The study evaluates postoperative pain scores, opioid consumption, and the need for rescue analgesics within the first 24 hours after surgery. By analyzing analgesic performance and safety profiles of these techniques, the study seeks to provide evidence to guide optimal postoperative pain management for patients undergoing minimally invasive thoracic procedures.
Adults aged 18-75 years
Scheduled for elective video-assisted thoracoscopic surgery (VATS)
ASA physical status I-III
Ability to understand study procedures and provide written informed consent
Known allergy or contraindication to local anesthetics or study medications
Coagulopathy or use of anticoagulants not suitable for regional anesthesia
Local infection or skin lesions at the injection site
Severe pulmonary disease (e.g., severe COPD, uncontrolled asthma)
Adult patients (18-75 years) undergoing elective video-assisted thoracoscopic surgery (VATS) under general anesthesia at a tertiary university hospital. Patients will receive SPSIPB, thoracic epidural analgesia, or systemic opioid analgesia as part of routine clinical practice, and will be followed for postoperative pain outcomes within the first 24 hours.
Cohort
Prospective
Not listed
Opioid Consumption
Total Opioid Consumption at 24 Hours
Pain Scores
Postoperative pain intensity will be assessed using the Numeric Rating Scale (NRS), which ranges from 0 to 10, where 0 = no pain and 10 = worst imaginable pain. Higher scores indicate worse pain.
Need for Rescue Analgesia
Number of patients requiring additional analgesics despite standard postoperative analgesia.
Incidence of Postoperative Nausea and Vomiting (PONV)
"PONV will be assessed using the Postoperative Nausea and Vomiting Intensity Scale (PONV Intensity Scale), which ranges from 0 to 3, where: 0 = No nausea or vomiting 1. = Mild nausea 2. = Moderate nausea or single episode of vomiting 3. = Severe nausea or two or more vomiting episodes Higher scores indicate more severe PONV. The presence of any nausea or vomiting and its severity will be recorded."
Heart Rate (beats per minute)
"Heart rate will be recorded intraoperatively and during the first 24 postoperative hours. Heart rate is measured in beats per minute (bpm). Higher values indicate increased sympathetic activity or hemodynamic stress."
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