This Study Evaluates the Effects of Different Fascial Plane Blocks on Intraoperative Anesthesia and Analgesic Consumption in Non-intubated VATS ProceduresNCT07440199
Comparison of SPSIP Block and SAP Block in Non-Intubated Uniportal VATS.
A study testing Serratus Anterior Plane Block (SAPB) group and Serratus posterior superior intercostal plane block group in people with This Study Evaluates the Effects of Different Fascial Plane Blocks on Intraoperative Anesthesia and Analgesic Consumption in Non-intubated VATS Procedures, run by Firat University at 1 site in Turkey (Türkiye).
Trial summary
Comparison of Serratus Posterior Superior Intercostal Plane Block and Serratus Anterior Plane Block in Uniportal Video-Assisted Thoracoscopic Surgery Without Intubation Single-port video-assisted thoracoscopic surgery without intubation (NI-UniVATS) is a technique in which video-assisted thoracoscopic surgery is… Read more about this study
- Who is it for?
- Ages 18 to 65 years
- Conditions the study is for
- This Study Evaluates the Effects of Different Fascial Plane Blocks on Intraoperative Anesthesia and Analgesic Consumption in Non-intubated VATS Procedures
- What is being tested?
- Serratus Anterior Plane Block (SAPB) group and Serratus posterior superior intercostal plane block group
- Type of treatment
- Injection or infusion, Surgery or procedure
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 70 participants
- Where
- 1 siteTurkey (Türkiye)
- Study dates
- 16 Jan 2026to 15 Aug 2026
- Phase
- Interventional
- Are there results?
- Not yet: the study is under way
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 to 65 years
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- The study included patients who:
- were aged 18-65 years,
- had an American Society of Anaesthesiologists (ASA) physical status classification of I-III,
- had a body mass index (BMI) < 35 kg/m²,
- read and signed the informed consent form.
Who cannot join
- Patients;
- Unable to communicate in Turkish or refusing to participate in the study,
- Unable to use the numerical pain rating scale (NRS),
- History of allergy to local anaesthetics or analgesics used in the study,
- Pregnant or breastfeeding,
- History of uncontrolled anxiety disorder or substance dependence,
Show all 14Show fewer
- Previous thoracic surgery or history of thoracic trauma,
- Widespread pleural adhesions detected during preoperative assessment,
- Neuromuscular or peripheral nervous system disease,
- Diabetes mellitus, hepatic or renal insufficiency, or coagulation disorder,
- Chronic opioid or steroid use,
- Widespread pain syndrome,
- Receiving anticoagulant therapy,
- Patients with infection detected in the area where the block will be applied were excluded.
Trial locations and contacts
1 site in 1 country. Contact the study team or a site near you to ask about taking part.
Turkey (Türkiye)1 site, 1 recruiting
- Recruiting
Fırat University Faculty of Medicine Hospital
Elâzığ, 23100
İsmail Demirel, Professor, +90 533 466 88 66, ismaildemirel23@firat.edu.tr
About this study
Official title: Comparison of Serratus Posterior Superior Intercostal Plane Block and Serratus Anterior Plane Block in Uniportal Video-Assisted Thoracoscopic Surgery Without Intubation
Comparison of Serratus Posterior Superior Intercostal Plane Block and Serratus Anterior Plane Block in Uniportal Video-Assisted Thoracoscopic Surgery Without Intubation Single-port video-assisted thoracoscopic surgery without intubation (NI-UniVATS) is a technique in which video-assisted thoracoscopic surgery is performed through a single port without intubating the patient. It differs significantly from traditional VATS. The literature reports that the uniportal approach provides surgical efficiency comparable to the multiportal approach, reduces postoperative pain scores, improves patient comfort due to shorter surgery, reduced chest tube use, and reduced hospital stay, and offers superior cosmetic results.
Beyond the limited surgical trauma associated with single-port delivery, NI-UniVATS allows maintenance of physiological ventilation by preventing positive pressure on the lungs while preserving spontaneous breathing. This feature helps reduce postoperative pulmonary complications, especially in patients with impaired lung function. Avoiding intubation reduces the risk of local complications such as postoperative sore throat, mucosal ulceration, laryngeal or tracheal injuries, and bronchospasm due to mechanical irritation, while not using neuromuscular blocking agents eliminates curare-related complications.
Read more
In addition, the administration of hypnotic and opioid agents in limited doses supports faster recovery and reduces the frequency of postoperative sedation, nausea, and vomiting. Consistent with these physiological and pharmacological advantages, NIVATS stands out as an effective, patient-centered surgical approach associated with shorter hospital stays and accelerated recovery.
In the transition from aggressive surgical approaches to minimally invasive methods for treating pleural, mediastinal, and pulmonary diseases, advancements in surgical techniques and progress in anesthesia have played a decisive role. In video-assisted thoracoscopic surgery (NI-VATS), which does not require intubation, the safe performance of the procedure requires the use of appropriate anesthetic techniques to protect patients from severe hypoxia and hypercapnia, to effectively control pain during surgical resection, and to suppress the cough reflex so that the lung can be manipulated more stably and safely.
Adequate and effective analgesia is a fundamental requirement for the success of this approach. Although thoracic epidural anesthesia and paravertebral blocks provide effective analgesia, facial plane blocks such as the serratus anterior plane block, rhomboid intercostal block, and erector spinae plane block can be used alone or in combination as the primary anesthetic method in NI-VATS procedures because of their ease of application and relatively low risk of complications.
The serratus posterior superior intercostal plane block (SPSIPB), described by Tulgar et al. in 2023, has been reported to provide effective analgesia in the anterolateral hemithorax, including the C3-T10 dermatomes. Consistent with these findings, it is increasingly used for postoperative analgesia in VATS surgery. In addition, one case reports successful NI-VATS without complications after SPSIPB application. Given these features, SPSIPB has the potential to be an effective anesthetic and analgesic option in NI-VATS patients.
In light of this data, identifying an effective, safe, and easily applicable regional analgesic technique for NI-VATS procedures is clinically important. Evidence comparing the efficacy of SPSIPB, a technique recently described and gaining increasing attention in thoracic surgery, with SAPB, a facial plane block commonly used in NI-VATS procedures, is limited. The aim of this study is to evaluate the perioperative anesthetic and analgesic efficacy of ultrasound-guided SPSIPB in patients undergoing NI-VATS, compared with SAPB. The hypothesis of this study is that the serratus posterior superior intercostal plane block is non-inferior to the serratus anterior plane block in terms of intraoperative anesthetic requirements, pain control, and perioperative analgesic requirements.
Materials and Methodology Study Design and Patient Selection This study was designed as a single-center, prospective, randomized, double-blind trial. The study protocol was approved by the Ethics Committee for Clinical Research at Fırat University Faculty of Medicine (Approval No: 2023-181). After approval, a total of 70 patients scheduled to undergo elective non-intubated uniportal video-assisted thoracoscopic surgery (NI-UniVATS) were included in the study. The research was conducted between 20 January 2026 and 15 August 2026.
Inclusion Criteria
The study included patients who:
- were aged 18-65 years,
- had an American Society of Anaesthesiologists (ASA) physical status classification of I-III,
- had a body mass index (BMI) < 35 kg/m²,
- read and signed the informed consent form. Exclusion Criteria
- Being tested
- Serratus Anterior Plane Block (SAPB) group, Serratus posterior superior intercostal plane block group
- Keywords
- NIVATS, Bullectomy, pleural biopsy, Serratus Posterior Superior Intercostal Block, Serratus Anterior Plan Block
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Serratus Anterior Plane Block (SAPB) groupProcedure or surgery
The anesthesiologist performing the block had more than three years of experience in ultrasound-guided regional anesthesia and applied the procedure according to the group assignment determined by sealed envelope. The patient in the SAPB group was positioned in the lateral decubitus position. SAPB was performed under ultrasound guidance using a high-frequency linear probe (LOGIQ e, GE Healthcare). The probe was placed parallel to the mid-axillary line, and the fifth rib was identified as a hyperechoic structure. Using an in-plane technique, 20 mL of 0.25% ropivacaine was injected into the myofascial plane between the serratus anterior muscle and the fifth rib. The needle was then withdrawn to the plane between the serratus anterior and latissimus dorsi muscles, and correct placement was confirmed by hydrodissection. After negative aspiration, an additional 10 mL of 0.25% ropivacaine was administered, and the needle was removed.
Serratus posterior superior intercostal plane block groupProcedure or surgery
The anesthesiologist performing the block had more than three years of experience in ultrasound-guided regional anesthesia and applied the procedure according to the group assignment determined by sealed envelope. In the SPSIPB group, patients were positioned in the lateral decubitus position. After slight lateral displacement of the scapula, the scapular spine was visualized, and the probe was moved medially to identify the superior angle of the scapula and the third rib. The block needle was advanced in a craniocaudal direction and positioned between the serratus posterior superior muscle and the third rib. Correct placement was confirmed by hydrodissection using 2 mL saline, followed by injection of 30 mL of 0.25% bupivacaine. Patients were monitored for 15 minutes in the procedure room, during which 5 mL of 2% lidocaine was administered via nebulization. Sensory block was assessed with a needle prick test over T1-T7 dermatomes before transfer to the operating theatre.
| Study group | Role | What they receive |
|---|---|---|
| Serratus posterior superior intercostal plane block Group | Active comparator | Not described Receives: Procedure: Serratus posterior superior intercostal plane block group |
| Serratus Anterior Plane Block (SAPB) group | Active comparator | Not described Receives: Procedure: Serratus Anterior Plane Block (SAPB) group |
What is being measured
The primary outcome is the main question the study is designed to answer.
Comparison of the intraoperative anesthetic and analgesic efficacy of ultrasound-guided SPSIPB with SAPB in patients undergoing NI-VATS. The primary outcome was intraoperative consumption of anesthetic and analgesic agents during the surgical procedure.
Measured: The amounts of remifentanyl and propofol consumed from the start to the end of the operation will also be recorded in both study groups.
Secondary outcomes (1)
Secondary outcomes included postoperative pain intensity measured by NRS, total analgesic consumption, time to first rescue analgesia, QoR-15 recovery scores, and the incidence of block-related complications.
Measured: Analgesic intake and NRS scores will be assessed at 1, 6, 12, 18, and 24 hours postoperatively.
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted27 Feb 2026
- Study start16 Jan 2026
- Primary completion15 Aug 2026 (estimated)
- Study completion15 Aug 2026 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for This Study Evaluates the Effects of Different Fascial Plane Blocks on Intraoperative Anesthesia and Analgesic Consumption in Non-intubated VATS ProceduresStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Supportive care
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Triple blind
- Who is masked
- Participant, Care provider, Investigator
- Enrolment
- 70 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Firat University
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, AHMET AKSU, Firat University
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07440199
- Sponsor's protocol ID
- 43756
- Status last verified
- Feb 2026
- First submitted
- 6 Feb 2026
- Last updated
- 27 Feb 2026
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No
Study at a glance
From the registry record, last updated by the sponsor on 27 Feb 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Comparison of Serratus Posterior Superior Intercostal Plane Block and Serratus Anterior Plane Block in Uniportal Video-Assisted Thoracoscopic Surgery Without Intubation
- ClinicalTrials.gov ID
- NCT07440199
- Acronym / sponsor ID
- 43756
- Keywords
- NIVATS, Bullectomy, pleural biopsy, Serratus Posterior Superior Intercostal Block, Serratus Anterior Plan Block
- Study type
- Interventional
- Recruitment status
- Recruiting
- Enrolment
- 70 participants (estimated)
- Lead sponsor
- Firat UniversityUniversity, hospital or other
- Study start
- 16 Jan 2026 (actual)
- Primary completion
- 15 Aug 2026 (estimated)
- Study completion
- 15 Aug 2026 (estimated)
- First posted
- 27 Feb 2026 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
Comparison of Serratus Posterior Superior Intercostal Plane Block and Serratus Anterior Plane Block in Uniportal Video-Assisted Thoracoscopic Surgery Without Intubation Single-port video-assisted thoracoscopic surgery without intubation (NI-UniVATS) is a technique in which video-assisted thoracoscopic surgery is performed through a single port without intubating the patient. It differs significantly from traditional VATS. The literature reports that the uniportal approach provides surgical efficiency comparable to the multiportal approach, reduces postoperative pain scores, improves patient comfort due to shorter surgery, reduced chest tube use, and reduced hospital stay, and offers superior cosmetic results.
Beyond the limited surgical trauma associated with single-port delivery, NI-UniVATS allows maintenance of physiological ventilation by preventing positive pressure on the lungs while preserving spontaneous breathing. This feature helps reduce postoperative pulmonary complications, especially in patients with impaired lung function. Avoiding intubation reduces the risk of local complications such as postoperative sore throat, mucosal ulceration, laryngeal or tracheal injuries, and bronchospasm due to mechanical irritation, while not using neuromuscular blocking agents eliminates curare-related complications.
In addition, the administration of hypnotic and opioid agents in limited doses supports faster recovery and reduces the frequency of postoperative sedation, nausea, and vomiting. Consistent with these physiological and pharmacological advantages, NIVATS stands out as an effective, patient-centered surgical approach associated with shorter hospital stays and accelerated recovery.
In the transition from aggressive surgical approaches to minimally invasive methods for treating pleural, mediastinal, and pulmonary diseases, advancements in surgical techniques and progress in anesthesia have played a decisive role. In video-assisted thoracoscopic surgery (NI-VATS), which does not require intubation, the safe performance of the procedure requires the use of appropriate anesthetic techniques to protect patients from severe hypoxia and hypercapnia, to effectively control pain during surgical resection, and to suppress the cough reflex so that the lung can be manipulated more stably and safely.
Adequate and effective analgesia is a fundamental requirement for the success of this approach. Although thoracic epidural anesthesia and paravertebral blocks provide effective analgesia, facial plane blocks such as the serratus anterior plane block, rhomboid intercostal block, and erector spinae plane block can be used alone or in combination as the primary anesthetic method in NI-VATS procedures because of their ease of application and relatively low risk of complications.
The serratus posterior superior intercostal plane block (SPSIPB), described by Tulgar et al. in 2023, has been reported to provide effective analgesia in the anterolateral hemithorax, including the C3-T10 dermatomes. Consistent with these findings, it is increasingly used for postoperative analgesia in VATS surgery. In addition, one case reports successful NI-VATS without complications after SPSIPB application. Given these features, SPSIPB has the potential to be an effective anesthetic and analgesic option in NI-VATS patients.
In light of this data, identifying an effective, safe, and easily applicable regional analgesic technique for NI-VATS procedures is clinically important. Evidence comparing the efficacy of SPSIPB, a technique recently described and gaining increasing attention in thoracic surgery, with SAPB, a facial plane block commonly used in NI-VATS procedures, is limited. The aim of this study is to evaluate the perioperative anesthetic and analgesic efficacy of ultrasound-guided SPSIPB in patients undergoing NI-VATS, compared with SAPB. The hypothesis of this study is that the serratus posterior superior intercostal plane block is non-inferior to the serratus anterior plane block in terms of intraoperative anesthetic requirements, pain control, and perioperative analgesic requirements.
Materials and Methodology Study Design and Patient Selection This study was designed as a single-center, prospective, randomized, double-blind trial. The study protocol was approved by the Ethics Committee for Clinical Research at Fırat University Faculty of Medicine (Approval No: 2023-181). After approval, a total of 70 patients scheduled to undergo elective non-intubated uniportal video-assisted thoracoscopic surgery (NI-UniVATS) were included in the study. The research was conducted between 20 January 2026 and 15 August 2026.
Inclusion Criteria
The study included patients who:
- were aged 18-65 years,
- had an American Society of Anaesthesiologists (ASA) physical status classification of I-III,
- had a body mass index (BMI) < 35 kg/m²,
- read and signed the informed consent form. Exclusion Criteria
Study design
- Primary purpose
- Supportive care
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Triple blind (participant, care provider, investigator)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Serratus posterior superior intercostal plane block Group | Active comparator | Procedure: Serratus posterior superior intercostal plane block group |
| Serratus Anterior Plane Block (SAPB) group | Active comparator | Procedure: Serratus Anterior Plane Block (SAPB) group |
Who may qualify
- Ages
- 18 to 65 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (5 listed)
- were aged 18-65 years,
- had an American Society of Anaesthesiologists (ASA) physical status classification of I-III,
- had a body mass index (BMI) < 35 kg/m²,
- read and signed the informed consent form.
Key exclusion criteria (14 listed)
- Patients;
- Unable to communicate in Turkish or refusing to participate in the study,
- Unable to use the numerical pain rating scale (NRS),
- History of allergy to local anaesthetics or analgesics used in the study,
- Pregnant or breastfeeding,
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Serratus Anterior Plane Block (SAPB) groupThe anesthesiologist performing the block had more than three years of experience in ultrasound-guided regional anesthesia and applied the procedure according to the group assignment determined by sealed envelope. The patient in the SAPB group was positioned in the lateral decubitus position. SAPB was performed under ultrasound guidance using a high-frequency linear probe (LOGIQ e, GE Healthcare). The probe was placed parallel to the mid-axillary line, and the fifth rib was identified as a hyperechoic structure. Using an in-plane technique, 20 mL of 0.25% ropivacaine was injected into the myofascial plane between the serratus anterior muscle and the fifth rib. The needle was then withdrawn to the plane between the serratus anterior and latissimus dorsi muscles, and correct placement was confirmed by hydrodissection. After negative aspiration, an additional 10 mL of 0.25% ropivacaine was administered, and the needle was removed. | Procedure or surgery | Serratus Anterior Plane Block (SAPB) group |
| Serratus posterior superior intercostal plane block groupThe anesthesiologist performing the block had more than three years of experience in ultrasound-guided regional anesthesia and applied the procedure according to the group assignment determined by sealed envelope. In the SPSIPB group, patients were positioned in the lateral decubitus position. After slight lateral displacement of the scapula, the scapular spine was visualized, and the probe was moved medially to identify the superior angle of the scapula and the third rib. The block needle was advanced in a craniocaudal direction and positioned between the serratus posterior superior muscle and the third rib. Correct placement was confirmed by hydrodissection using 2 mL saline, followed by injection of 30 mL of 0.25% bupivacaine. Patients were monitored for 15 minutes in the procedure room, during which 5 mL of 2% lidocaine was administered via nebulization. Sensory block was assessed with a needle prick test over T1-T7 dermatomes before transfer to the operating theatre. | Procedure or surgery | Serratus posterior superior intercostal plane block Group |
Primary outcome
Comparison of the intraoperative anesthetic and analgesic efficacy of ultrasound-guided SPSIPB with SAPB in patients undergoing NI-VATS. The primary outcome was intraoperative consumption of anesthetic and analgesic agents during the surgical procedure.
Time frame: The amounts of remifentanyl and propofol consumed from the start to the end of the operation will also be recorded in both study groups.
1 secondary outcome
Secondary outcomes included postoperative pain intensity measured by NRS, total analgesic consumption, time to first rescue analgesia, QoR-15 recovery scores, and the incidence of block-related complications.
Time frame: Analgesic intake and NRS scores will be assessed at 1, 6, 12, 18, and 24 hours postoperatively.
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 27 Feb 2026.
- Individual participant dataSharing planned: No
Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part.
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Serratus Anterior Plane Block (SAPB) group and Serratus posterior superior intercostal plane block group in people with This Study Evaluates the Effects of Different Fascial Plane Blocks on Intraoperative Anesthesia and Analgesic Consumption in Non-intubated VATS Procedures, run by Firat University at 1 site in Turkey (Türkiye).
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 5 inclusion and 14 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: looking for participants now, as of the sponsor's last update on 27 Feb 2026. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in Turkey (Türkiye). Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
This study is still under way. Results are not available in the source record yet.
How can a doctor refer a patient or contact the research team?
Contact AHMET AKSU, Assistant Professor (+90-530-349-3896, aaksu@firat.edu.tr), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Comparison of the intraoperative anesthetic and analgesic efficacy of ultrasound-guided SPSIPB with SAPB in patients undergoing NI-VATS. The primary outcome was intraoperative consumption of anesthetic and analgesic agents during the surgical procedure. (time frame: The amounts of remifentanyl and propofol consumed from the start to the end of the operation will also be recorded in both study groups.). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 27 Feb 2026.