Postoperative Pain ManagementNCT07524673
Comprasion of SPSIP and Rhomboid Intercostal Plan Blocks on VATS
A study testing RIB BLOCK and SPSIP block in people with Postoperative Pain Management, run by Cumhuriyet University at 2 sites in Turkey (Türkiye).
Trial summary
This study aimed to compare rhomboid intercostal plane block and serratus posterior superior intercostal plane block (SPSIPB) to determine the most suitable technique for maintaining postoperative analgesia in video-assisted thoracoscopic surgeries (VATS). Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Postoperative Pain Management
- What is being tested?
- RIB BLOCK and SPSIP block
- Type of treatment
- Surgery or procedure
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 40 participants
- Where
- 2 sitesTurkey (Türkiye)
- Study dates
- 12 Mar 2026to Dec 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 years and older
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Forty adult patients scheduled for elective wedge resection or biopsy under VATS, classified as American Society of Anesthesiologists (ASA) physical status I-III, were enrolled after providing written informed consent.
Who cannot join
- ASA class IV or higher,
- morbid obesity (BMI > 40 kg/m²),
- body weight ≤ 50 kg,
- skin infection at the block site,
- refusal to participate,
- inability to cooperate during postoperative pain assessment,
Show all 10Show fewer
- conversion to open surgery,
- preexisting pain,
- known allergy to any study medication,
- coagulopathy.
Trial locations and contacts
2 sites in 1 country. Contact the study team or a site near you to ask about taking part.
Turkey (Türkiye)2 sites, 1 recruiting
- Completed
Sivas Cumhuriyet University
Sivas, Merkez, 58000
- Recruiting
Sivas Cumhuriyet University School of Medicine, Anesthesiology and Reanimation
Sivas, Sivas, 58140
OĞUZ GÜNDOĞDU, +905544595469, droguzgundogdu@gmail.com
About this study
Official title: Comparison of the Analgesic Efficacy of Rhomboid Intercostal Plane Block and Serratus Posterior Superior Intercostal Plane Block on Postoperative Pain in Patients Undergoing Video-Assisted Thoracoscopic Surgery
This study aimed to compare rhomboid intercostal plane block and serratus posterior superior intercostal plane block (SPSIPB) to determine the most suitable technique for maintaining postoperative analgesia in video-assisted thoracoscopic surgeries (VATS).
Read the detailed description
Patients were randomly allocated into two groups: RIB and SPSIPB. All patients received postoperative paracetamol and dexketoprofen, and intravenous tramadol hydrochloride was administered via patient-controlled analgesia. Postoperative static and dynamic NRS scores, total tramadol consumption, side effects, and the need for additional analgesia were monitored and recorded at regular intervals. Primary outcome was NRS scores and secondary outcome was total tramadol consumption.
Block Techniques
All blocks were performed following surgical closure, prior to extubation, with the patient in lateral decubitus and the skin prepared with 10% povidone-iodine.
RIB:Rhomboid intercostal plane block procedure is performed using a high-frequency linear ultrasound probe. First, the rhomboid and intercostal muscles are located in the area called the auscultation triangle, at the level of thoracic 4-5 o'clock. A needle, visible on ultrasound, is advanced between the rhomboid and intercostal muscles using an in-plane technique. After aspiration is performed to ensure no blood or air is present, a total of 30 ml of 0.25% bupivacaine will be injected between the two muscle planes. The rhomboid intercostal plane block creates sensory paresthesia (sensory numbness) in a dermatomal region between T3 and T9 o'clock.
SPSIPB: The USG probe was placed 2-3 cm medial to the scapular spine to visualize the trapezius, rhomboid major, and serratus posterior superior muscles. At the level of the 2nd-3rd ribs, a needle was advanced into the plane between the serratus posterior superior muscle and the rib. After confirming negative aspiration, 30 mL of 0.25% bupivacaine was injected.
All blocks were performed unilaterally, targeting the surgical hemithorax.
Postoperative Analgesia and Assessments
Twenty minutes before extubation, all patients received 1 g IV paracetamol and 50 mg IV dexketoprofen. In the recovery room, patient-controlled analgesia (PCA) with IV tramadol hydrochloride was initiated (4 mg/mL concentration, 10 mg bolus, 20-minute lockout, maximum 3 boluses/hour).
Postoperative NRS scores (static at rest and dynamic during movement or coughing) were recorded at 0, 1, 2, 6, 12, 18, and 24 hours. The first NRS assessment (0 hour) was performed when the patient achieved an Aldrete score of 9. If NRS ≥ 4, an additional 50 mg IV tramadol was administered. Additional analgesic consumption was recorded. Side effects such as nausea, vomiting, and pruritus were documented.
- Conditions
- Postoperative Pain Management
- Being tested
- RIB BLOCK, SPSIP block
- Keywords
- rhomboid intercostal plane block, serratus posterior superior intercostal plane block, vats, video-assisted thoracoscopic surgery, postoperative pain
- Medical subject headings
- Pain, Postoperative
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
RIB BLOCKProcedure or surgery
30 mL of 0.25% bupivacaine was injected deep to the rhomboid intercostal spinal block.
SPSIP blockProcedure or surgery
The USG probe was placed 2-3 cm medial to the scapular spine to visualize the trapezius, rhomboid major, and serratus posterior superior muscles. At the level of the 2nd-3rd ribs, a needle was advanced into the plane between the serratus posterior superior muscle and the rib. After confirming negative aspiration, 30 mL of 0.25% bupivacaine was injected. The block was performed unilaterally, targeting the surgical hemithorax.
| Study group | Role | What they receive |
|---|---|---|
| SPSIP BLOCK | Active comparator | Arm Description: The USG probe was placed 2-3 cm medial to the scapular spine to visualize the trapezius, rhomboid major, and serratus posterior superior muscles. At the level of the 2nd-3rd ribs, a needle was advanced into the plane between the serratus posterior superior muscle and the rib. After confirming negative aspiration, 30 mL of 0.25% bupivacaine was injected. The block was performed unilaterally, targeting the surgical hemithorax. Receives: Procedure: SPSIP block |
| RIB BLOCK | Active comparator | Arm Description:Rhomboid intercostal plane block procedure, 10% povidone-iodine will be used for skin cleansing. The procedure is performed using a high-frequency linear ultrasound probe. First, the rhomboid and intercostal muscles are located in the area called the auscultation triangle, at the level of thoracic 4-5 o'clock. A needle, visible on ultrasound, is advanced between the rhomboid and intercostal muscles using an in-plane technique. After aspiration is performed to ensure no blood or air is present, a total of 30 ml of 0.25% bupivacaine will be injected between the two muscle planes. The rhomboid intercostal plane block creates sensory paresthesia (sensory numbness) in a dermatomal region between T3 and T9 o'clock. Receives: Procedure: RIB BLOCK |
What is being measured
The primary outcome is the main question the study is designed to answer.
NUMERICAL RATING SCORE(NRS)
Numerical rating scale is used for pain assessment. The scores of the numerical rating scale changes between 0 to 10 points. 10 points mean "the most severe pain that the patient ever had". 0 point means "there is no pain." Higher scores mean worse outcome.
Measured: postoperative 24 hours
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted13 Apr 2026
- Study start12 Mar 2026
- Primary completionNov 2026 (estimated)
- Study completionDec 2026 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Postoperative Pain ManagementStudies 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
- Other
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Quadruple blind
- Who is masked
- Participant, Care provider, Investigator, Outcomes assessor
- Enrolment
- 40 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Cumhuriyet University
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Oguz Gundogdu, Cumhuriyet University
- Investigators
- Oğuz Gündoğdu, Principal investigator, Sivas Cumhuriyet University School of Medicine, Anesthesiology and Reanimation
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07524673
- Sponsor's protocol ID
- 2026-04/01
- Status last verified
- Jun 2026
- First submitted
- 6 Apr 2026
- Last updated
- 3 Jun 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 3 Jun 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Comparison of the Analgesic Efficacy of Rhomboid Intercostal Plane Block and Serratus Posterior Superior Intercostal Plane Block on Postoperative Pain in Patients Undergoing Video-Assisted Thoracoscopic Surgery
- ClinicalTrials.gov ID
- NCT07524673
- Acronym / sponsor ID
- 2026-04/01
- Conditions
- Postoperative Pain Management
- Keywords
- rhomboid intercostal plane block, serratus posterior superior intercostal plane block, vats, video-assisted thoracoscopic surgery, postoperative pain
- Study type
- Interventional
- Recruitment status
- Recruiting
- Enrolment
- 40 participants (estimated)
- Lead sponsor
- Cumhuriyet UniversityUniversity, hospital or other
- Study start
- 12 Mar 2026 (actual)
- Primary completion
- Nov 2026 (estimated)
- Study completion
- Dec 2026 (estimated)
- First posted
- 13 Apr 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.
This study aimed to compare rhomboid intercostal plane block and serratus posterior superior intercostal plane block (SPSIPB) to determine the most suitable technique for maintaining postoperative analgesia in video-assisted thoracoscopic surgeries (VATS).
Detailed description
Patients were randomly allocated into two groups: RIB and SPSIPB. All patients received postoperative paracetamol and dexketoprofen, and intravenous tramadol hydrochloride was administered via patient-controlled analgesia. Postoperative static and dynamic NRS scores, total tramadol consumption, side effects, and the need for additional analgesia were monitored and recorded at regular intervals. Primary outcome was NRS scores and secondary outcome was total tramadol consumption.
Block Techniques
All blocks were performed following surgical closure, prior to extubation, with the patient in lateral decubitus and the skin prepared with 10% povidone-iodine.
RIB:Rhomboid intercostal plane block procedure is performed using a high-frequency linear ultrasound probe. First, the rhomboid and intercostal muscles are located in the area called the auscultation triangle, at the level of thoracic 4-5 o'clock. A needle, visible on ultrasound, is advanced between the rhomboid and intercostal muscles using an in-plane technique. After aspiration is performed to ensure no blood or air is present, a total of 30 ml of 0.25% bupivacaine will be injected between the two muscle planes. The rhomboid intercostal plane block creates sensory paresthesia (sensory numbness) in a dermatomal region between T3 and T9 o'clock.
SPSIPB: The USG probe was placed 2-3 cm medial to the scapular spine to visualize the trapezius, rhomboid major, and serratus posterior superior muscles. At the level of the 2nd-3rd ribs, a needle was advanced into the plane between the serratus posterior superior muscle and the rib. After confirming negative aspiration, 30 mL of 0.25% bupivacaine was injected.
All blocks were performed unilaterally, targeting the surgical hemithorax.
Postoperative Analgesia and Assessments
Twenty minutes before extubation, all patients received 1 g IV paracetamol and 50 mg IV dexketoprofen. In the recovery room, patient-controlled analgesia (PCA) with IV tramadol hydrochloride was initiated (4 mg/mL concentration, 10 mg bolus, 20-minute lockout, maximum 3 boluses/hour).
Postoperative NRS scores (static at rest and dynamic during movement or coughing) were recorded at 0, 1, 2, 6, 12, 18, and 24 hours. The first NRS assessment (0 hour) was performed when the patient achieved an Aldrete score of 9. If NRS ≥ 4, an additional 50 mg IV tramadol was administered. Additional analgesic consumption was recorded. Side effects such as nausea, vomiting, and pruritus were documented.
Study design
- Primary purpose
- Other
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Quadruple blind (participant, care provider, investigator, outcomes assessor)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| SPSIP BLOCK | Active comparator | Procedure: SPSIP blockArm Description: The USG probe was placed 2-3 cm medial to the scapular spine to visualize the trapezius, rhomboid major, and serratus posterior superior muscles. At the level of the 2nd-3rd ribs, a needle was advanced into the plane between the serratus posterior superior muscle and the rib. After confirming negative aspiration, 30 mL of 0.25% bupivacaine was injected. The block was performed unilaterally, targeting the surgical hemithorax. |
| RIB BLOCK | Active comparator | Procedure: RIB BLOCKArm Description:Rhomboid intercostal plane block procedure, 10% povidone-iodine will be used for skin cleansing. The procedure is performed using a high-frequency linear ultrasound probe. First, the rhomboid and intercostal muscles are located in the area called the auscultation triangle, at the level of thoracic 4-5 o'clock. A needle, visible on ultrasound, is advanced between the rhomboid and intercostal muscles using an in-plane technique. After aspiration is performed to ensure no blood or air is present, a total of 30 ml of 0.25% bupivacaine will be injected between the two muscle planes. The rhomboid intercostal plane block creates sensory paresthesia (sensory numbness) in a dermatomal region between T3 and T9 o'clock. |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (1 listed)
- Forty adult patients scheduled for elective wedge resection or biopsy under VATS, classified as American Society of Anesthesiologists (ASA) physical status I-III, were enrolled after providing written informed consent.
Key exclusion criteria (10 listed)
- ASA class IV or higher,
- morbid obesity (BMI > 40 kg/m²),
- body weight ≤ 50 kg,
- skin infection at the block site,
- refusal to participate,
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 |
|---|---|---|
| RIB BLOCK30 mL of 0.25% bupivacaine was injected deep to the rhomboid intercostal spinal block. | Procedure or surgery | RIB BLOCK |
| SPSIP blockThe USG probe was placed 2-3 cm medial to the scapular spine to visualize the trapezius, rhomboid major, and serratus posterior superior muscles. At the level of the 2nd-3rd ribs, a needle was advanced into the plane between the serratus posterior superior muscle and the rib. After confirming negative aspiration, 30 mL of 0.25% bupivacaine was injected. The block was performed unilaterally, targeting the surgical hemithorax. | Procedure or surgery | SPSIP BLOCK |
Primary outcome
NUMERICAL RATING SCORE(NRS)
Time frame: postoperative 24 hours
Numerical rating scale is used for pain assessment. The scores of the numerical rating scale changes between 0 to 10 points. 10 points mean "the most severe pain that the patient ever had". 0 point means "there is no pain." Higher scores mean worse outcome.
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 3 Jun 2026.
- Individual participant dataSharing planned: No
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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.
Oğuz Gündoğdu principal investigator
Sivas Cumhuriyet University School of Medicine, Anesthesiology and Reanimation
2 sites in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing RIB BLOCK and SPSIP block in people with Postoperative Pain Management, run by Cumhuriyet University at 2 sites 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 1 inclusion and 10 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 3 Jun 2026. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 2 sites 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 Oğuz Gündoğdu (+905545945469, droguzgundogdu@gmail.com), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
NUMERICAL RATING SCORE(NRS) (time frame: postoperative 24 hours). 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 3 Jun 2026.