This randomized, double-blind, placebo-controlled study aims to evaluate the effect of the serratus posterior superior intercostal plane (SPSIP) block on postoperative pain and opioid consumption in patients undergoing minimally invasive cardiac valve surgery via mini-thoracotomy.
Adult patients aged 18-75 years
ASA physical status I-III
Scheduled for elective minimally invasive cardiac valve surgery via mini-thoracotomy
Able to understand and use the Numeric Rating Scale (NRS)
Age >75 years
Known allergy or hypersensitivity to local anesthetics (e.g., bupivacaine)
Coagulopathy or ongoing anticoagulant therapy that cannot be discontinued
Infection at the planned block site
Parallel
Serratus Posterior Superior Intercostal Plane Block With Bupivacaine
Procedure/SurgeryParticipants in this group will receive an ultrasound-guided serratus posterior superior intercostal plane (SPSIP) block prior to surgery using 30 mL of 0.25% bupivacaine, in addition to standard general anesthesia and multimodal analgesia.
Serratus Posterior Superior Intercostal Plane Block With Saline
Procedure/SurgeryParticipants in this group will receive an ultrasound-guided placebo block using 30 mL of normal saline under identical conditions, in addition to standard general anesthesia and multimodal analgesia.
24-hour cumulative opioid consumption
Total opioid consumption within the first 24 hours after surgery, expressed as intravenous morphine milligram equivalents (IV-MME).
Postoperative pain intensity at rest (NRS)
Pain intensity at rest measured using the Numeric Rating Scale (0-10).
Postoperative pain during movement (NRS)
Pain intensity during coughing or deep breathing measured using the Numeric Rating Scale (0-10).
Time to first rescue analgesia
Time from the end of surgery to the first administration of rescue analgesia.
Time to extubation
Time from the end of surgery to extubation.
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