Postoperative Pain, Thoracic Surgery, Video-Assisted Thoracic Surgery
Conditions
Brief summary
This prospective randomized controlled trial evaluates the efficacy and safety of ultrasound-guided rhomboid intercostal and subserratus plane (RISS) block for postoperative analgesia in patients undergoing video-assisted thoracoscopic surgery (VATS). Postoperative pain after VATS can impair respiratory function, delay mobilization, and increase opioid consumption. Although several regional anesthesia techniques are available, the optimal analgesic strategy remains under investigation. The RISS block is a novel fascial plane block that may provide effective thoracic analgesia while minimizing opioid-related adverse effects. A total of 90 adult patients scheduled for elective VATS will be randomly assigned to receive either ultrasound-guided RISS block combined with general anesthesia or general anesthesia alone. The primary outcomes include postoperative 24-hour benefit of analgesia score (BCS) and patient-controlled intravenous analgesia (PCIA) pressing frequency. Secondary outcomes include postoperative pain scores, opioid consumption, and adverse events. This study aims to determine whether RISS block improves postoperative recovery and reduces opioid requirements after VATS.
Interventions
Ultrasound-guided dual-plane RISS block performed after induction of general anesthesia. A total of 40 mL of 0.375% ropivacaine (150 mg) was administered across the rhomboid-intercostal plane and low subserratus plane.
PROCEDUREIntercostal nerve block
Ultrasound-guided intercostal nerve block performed at surgical port levels (T4-T7) using 0.375% ropivacaine with total dose ≤75 mg.
Sponsors
Ningbo University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
DOUBLE (Subject, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
Adults aged 18 years or older ASA physical status I-II Scheduled for elective video-assisted thoracoscopic surgery (VATS) Provided written informed consent
Exclusion criteria
History of shock or coma Coagulopathy Local infection at the puncture site Pre-existing nerve injury on the side intended for block Chronic analgesic use Psychiatric disorders Prior thoracic or breast surgery Allergy to local or general anaesthetic agents Body mass index (BMI) ≥35 kg/m² Inability to operate a patient-controlled analgesia (PCA) device
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| 24-hour cumulative number of effective PCA presses | Within 24 hours postoperatively |
| Bruggrmann Comfort Scale (BCS) score at 24 hours | 24 hours after surgery |
Countries
China
Outcome results
None listed