Adding a serratus anterior plane block to a rhomboid intercostal block for pain control after VATS

Assessing the Impact of Additional Serratus Anterior Block Within 24-Hour on Postoperative Pain After Rhomboid Intercostal Block in VATS Patients

We will try adding a serratus anterior plane block to the usual rhomboid intercostal block for adults having VATS to see if it reduces postoperative pain and opioid use within 48 hours.

Quick facts

• Phase: Not applicable
• Study type: Interventional
• Enrollment: 50 (estimated)
• Ages: 18 Years to 70 Years
• Sex: All
• Sponsor: Al-Quds University (Academic / other)
• Locations: 1 site (Hebron)
• Trial ID: NCT06838039 on ClinicalTrials.gov

What this trial studies

This randomized controlled trial will enroll 50 adults (ages 18–70, ASA I–III) undergoing video-assisted thoracoscopic surgery and randomize them to receive either a rhomboid intercostal block (RIB) alone or RIB plus a serratus anterior plane block (SAPB). The blocks are ultrasound-guided and performed perioperatively at a single center (Al Ahli Hospital, Hebron). Pain intensity using the Visual Analog Scale, opioid consumption, and patient satisfaction will be recorded over the first 48 hours after surgery. The trial aims to determine whether the combined RIB+SAPB approach provides superior pain control and lower opioid use compared with RIB alone.

Who should consider this trial

Good fit: Ideal candidates are adults aged 18–70 undergoing VATS who are ASA physical status I–III and able to provide informed consent.

Not a fit: Patients with chronic opioid dependence, bleeding disorders or anticoagulant use, anatomical barriers to regional blocks, pregnancy, or inability to consent are excluded and unlikely to benefit from this protocol.

Why it matters

Potential benefit: If successful, the combined RIB+SAPB approach could lower postoperative pain scores and reduce opioid requirements after VATS.

How similar studies have performed: Previous studies have shown that both RIB and SAPB can reduce pain and opioid use after thoracic procedures, but combining the two techniques is less well studied.

Eligibility criteria

Inclusion Criteria:

1. Adults aged 18-70 years.
2. Patients undergoing Video-Assisted Thoracoscopic Surgery (VATS).
3. Classified as ASA physical status I-III (low to moderate surgical risk).
4. Ability to provide informed consent and follow study protocols.

Exclusion Criteria:

1. Known allergy or hypersensitivity to local anesthetics.
2. Presence of bleeding disorders or anticoagulant use.
3. History of chronic opioid use or opioid dependence.
4. Anatomical abnormalities or conditions preventing the application of regional anesthesia (e.g., chest wall deformities).
5. Presence of neurological disorders affecting pain perception.
6. Cognitive impairments, language barriers, or inability to communicate effectively.
7. Pregnancy or breastfeeding.
8. Refusal or inability to provide informed consent.

Where this trial is running

Hebron

• Al Ahli hospital — Hebron, Palestinian Territories (Recruiting)

Study contacts

• Study coordinator: Mohammed Adel Adwan, MD

Conditions Post Operative Pain; VATS; Postoperative Pain Management; Video-Assisted Thoracoscopic Surgery