Two-Point Versus Single-Point Serratus Anterior Plane Block for Post-Thoracoscopic Surgery Analgesia
Trial statusNot yet recruiting
Trial phaseNot listed
Trial typeObservational
Biological sexAll
Age18-85
SponsorShiyou Wei
About this trial
Postoperative pain remains a common clinical challenge in patients undergoing video-assisted thoracoscopic surgery (VATS), impairing early recovery and increasing opioid consumption. The serratus anterior plane block (SAPB) is a widely used regional analgesic technique for thoracic surgery, but conventional single-point injection may have limited spread of local anesthetics, resulting in suboptimal analgesia in some patients. Preliminary anatomical evidence suggests that two-point combined SAPB may achieve wider dermatomal coverage and better analgesic efficacy.
This is a single-center, prospective observational cohort study conducted at Shanghai Pulmonary Hospital, China. A total of 88 adult patients scheduled for elective unilateral VATS will be consecutively enrolled and naturally assigned to either the two-point combined SAPB group (injection at the 3rd and 5th rib levels, total 30 ml local anesthetic) or the single-point SAPB group (injection at the 5th rib level, 30 ml local anesthetic) according to routine clinical practice.
The primary outcome is the verbal rating scale (VRS) pain score on coughing at 24 hours postoperatively. Secondary outcomes include resting and dynamic pain scores at multiple time points, cumulative opioid consumption at 24 and 48 hours, incidence of postoperative nausea and vomiting, block-related complications, length of hospital stay, and Quality of Recovery-15 (QoR-15) scores. This study aims to provide clinical evidence for optimizing perioperative analgesic strategies for thoracoscopic surgery.
Eligibility criteria
This trial does not accept healthy volunteersQualifiers
Aged 18 to 85 years at enrollment, regardless of sex
American Society of Anesthesiologists (ASA) physical status grade I to III
Scheduled for elective unilateral video-assisted thoracoscopic surgery
Planned to receive ultrasound-guided SAPB for routine perioperative analgesia
Disqualifiers
Local infection or skin lesion at the block puncture site
Known hypersensitivity or allergy to amide local anesthetics
Preexisting sensory abnormality in the chest wall surgical area
Chronic opioid use for > 3 months, history of chronic pain syndrome, or history of opioid abuse
Trial population
This single-center, prospective observational cohort study is conducted at Shanghai Pulmonary Hospital, Tongji University School of Medicine, China. It enrolls adults aged 18-85 years with ASA physical status I-III, scheduled for elective unilateral video-assisted thoracoscopic surgery and planned for ultrasound-guided serratus anterior plane block as routine perioperative analgesia.Eligible participants will be consecutively enrolled after written informed consent. Patients are naturally assigned to two cohorts based on the block regimen selected by the attending anesthesiologist in standard clinical practice, with a target total sample size of 88 (\~44 per cohort). No study-initiated randomization or treatment intervention is applied; all clinical management follows institutional routine protocols.
Trial design
Design model
Cohort
Time perspective
Prospective
Treatments tested in this trial
Two-Point Serratus Anterior Plane Block
Procedure/SurgeryUltrasound-guided fascial plane block for perioperative thoracic analgesia. Local anesthetic is deposited deep to the serratus anterior muscle at two separate rib levels, with equal volume split between the 3rd and 5th intercostal spaces.
Single-Point Serratus Anterior Plane Block
Procedure/SurgeryUltrasound-guided fascial plane block for perioperative thoracic analgesia. A single bolus of local anesthetic is deposited deep to the serratus anterior muscle at the 5th intercostal level.
Treatment groups
88 Participants
are divided into 2 treatment groupsGroup A: Two-Point SAPB Group1 intervention
Group B: Single-Point SAPB Group1 intervention
Trial outcomes
Primary outcomes
1
Verbal Rating Scale (VRS) Pain Score on Coughing at 24 Hours Postoperatively
Dynamic pain intensity assessed using a 0-10 verbal rating scale (0 = no pain, 10 = worst imaginable pain) when the patient performs coughing.
Time frame
24 hours after surgerySecondary outcomes
1
Resting Verbal Rating Scale (VRS) Pain Scores
Resting pain measured using a 0-10 verbal rating scale at multiple postoperative time points.
Time frame
1 hour, 6 hours, 12 hours, 24 hours, 48 hours after surgery2
Cumulative Postoperative Opioid Consumption
Total opioid consumption after surgery, converted to standard intravenous morphine equivalents.
Time frame
24 hours and 48 hours after surgery3
Incidence of Postoperative Nausea and Vomiting (PONV)
Proportion of patients experiencing nausea and/or vomiting within 48 hours after surgery.
Time frame
Within 48 hours after surgery4
Incidence of Block-Related Adverse Events
Proportion of patients with block-related complications, including pneumothorax, local hematoma, and local anesthetic toxicity.
Time frame
Within 48 hours after surgeryLocations
Sponsors and contacts
Click on the lead sponsor to view all of their trials.
Shiyou Wei
Lead sponsor
Shanghai Pulmonary Hospital, Shanghai, China
Sponsor institution
Source ClinicalTrials.gov
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