Serratus Posterior Superior Intercostal Plane Block in Minimally Invasive Cardiac Surgery

This study is a prospective, randomized, double-blind, placebo-controlled clinical trial designed to evaluate the analgesic efficacy of the serratus posterior superior intercostal plane (SPSIP) block in patients undergoing minimally invasive cardiac valve surgery via mini-thoracotomy. Postoperative pain following thoracic cardiac surgery may impair respiratory function and delay recovery, making effective analgesia essential.

Participants will be randomly assigned to receive an ultrasound-guided SPSIP block with either bupivacaine or normal saline under identical conditions. All patients will receive standardized general anesthesia and postoperative multimodal analgesia. Blinding will be ensured for patients and outcome assessors.

The study aims to determine whether SPSIP block with local anesthetic reduces postoperative opioid consumption and improves pain control compared to placebo.

Inclusion criteria

• 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)
• Provided written informed consent

Exclusion criteria

• 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
• Chronic opioid use or chronic pain conditions
• Severe pulmonary disease affecting respiratory assessment
• Neurological or psychiatric disorders interfering with pain assessment
• Emergency surgery
• Pregnancy or breastfeeding
• Refusal to participate