Video-assisted thoracoscopic surgery (VATS) is associated with moderate to severe postoperative pain despite its minimally invasive nature. Ultrasound-guided erector spinae plane block (ESPB) and serratus posterior superior intercostal plane block (SPSIPB) are promising regional analgesic techniques for thoracic surgery; however, evidence directly comparing their effects on postoperative quality of recovery remains limited. This prospective, randomized, double-blind controlled trial aims to compare the effects of ESPB and SPSIPB on postoperative quality of recovery, measured by the Quality of Recovery-15 (QoR-15) questionnaire at 24 hours after surgery. Secondary outcomes include postoperative pain scores, tramadol consumption, time to first rescue analgesia, rescue analgesic requirement, postoperative nausea and vomiting, patient satisfaction, length of hospital stay, block-related complications, and perioperative hemodynamic parameters.
Adults aged 18-85 years.
ASA physical status I-III.
Scheduled for elective VATS under general anesthesia.
Able to understand and complete the QoR-15 questionnaire.
Refusal to participate or inability to provide written informed consent.
Known allergy or contraindication to bupivacaine, paracetamol, dexketoprofen, or tramadol.
Infection at the planned block injection site.
Coagulopathy or ongoing anticoagulant therapy precluding regional anesthesia.
Parallel
ESPB
Procedure/SurgeryAn ultrasound-guided erector spinae plane block will be performed preoperatively for postoperative analgesia in patients undergoing elective video-assisted thoracoscopic surgery. The block will be performed using the standardized study protocol.
SPSIPB
Procedure/SurgeryAn ultrasound-guided serratus posterior superior intercostal plane block will be performed preoperatively for postoperative analgesia in patients undergoing elective video-assisted thoracoscopic surgery. The block will be performed using the standardized study protocol.
Quality of Recovery-15 (QoR-15) Score
Postoperative quality of recovery will be assessed using the validated Turkish version of the Quality of Recovery-15 questionnaire. The total score ranges from 0 to 150, with higher scores indicating better recovery. The preoperative QoR-15 score will be recorded as a baseline measurement and considered in the analysis of the postoperative 24-hour score.
Postoperative Pain at Rest
Postoperative pain intensity at rest will be assessed using an 11-point Numerical Rating Scale (NRS), with scores ranging from 0 (no pain) to 10 (worst imaginable pain).
Postoperative Pain Intensity During Coughing
Postoperative pain intensity during coughing will be assessed using an 11-point Numerical Rating Scale (NRS), with scores ranging from 0 (no pain) to 10 (worst imaginable pain).
Time to First Rescue Analgesia
The time from arrival in the post-anesthesia care unit (PACU) to the first administration of rescue analgesia will be recorded in minutes.
Cumulative Postoperative Tramadol Consumption
The total amount of tramadol administered for postoperative rescue analgesia during the first 24 hours after surgery will be recorded in milligrams (mg).
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