Serratus posterior superior intercostal plane block versus intrathecal morphine for pain after video-assisted thoracic surgery

Comparison of the Effects of Serratus Posterior Superior Intercostal Plane Block and Intrathecal Morphine on Postoperative Acute Pain in Patients Undergoing Video-assisted Thoracoscopic Surgery

NA · Ondokuz Mayıs University · NCT07540104

We will test whether a serratus posterior superior intercostal plane block or a single-shot intrathecal morphine injection gives better pain control for adults having video-assisted thoracic surgery.

Quick facts

PhaseNA
Study typeInterventional
Enrollment60 (estimated)
Ages18 Years to 75 Years
SexAll
SponsorOndokuz Mayıs University (other)
Locations1 site (Atakent, Samsun)
Trial IDNCT07540104 on ClinicalTrials.gov

What this trial studies

This is a single-center, prospective, randomized, single-blinded, parallel-group trial enrolling adults undergoing elective video-assisted thoracoscopic procedures. Participants are randomized 1:1 to receive either an ultrasound-guided serratus posterior superior intercostal plane block or a single intrathecal morphine injection before induction of general anesthesia, with standardized intraoperative care and postoperative patient-controlled analgesia. The primary outcome is cumulative opioid consumption in the first 24 postoperative hours expressed as IV morphine milligram equivalents. Secondary outcomes include early pain scores at rest and movement, time to first analgesic request, quality of recovery, and common postoperative complications up to 30 days.

Who should consider this trial

Good fit: Adults 18–75 years old with ASA physical status I–III scheduled for elective VATS procedures (wedge resection, segmentectomy, or lobectomy) are eligible.

Not a fit: Patients using preoperative opioids, with bleeding disorders or on anticoagulants, active infection, morbid obesity (BMI >40), severe systemic disease, or other listed exclusions are not expected to benefit from the interventions tested in this protocol.

Why it matters

Potential benefit: If successful, the study could identify the technique that reduces opioid requirements and improves early postoperative pain control after VATS.

How similar studies have performed: Intrathecal morphine and various thoracic plane blocks have shown efficacy for postoperative thoracic pain in prior studies, but direct head-to-head data specifically comparing intrathecal morphine with the serratus posterior superior intercostal plane block are limited.

Eligibility criteria

Show full inclusion / exclusion criteria
Inclusion Criteria:

* Age between 18 and 75 years
* American Society of Anesthesiologists physical status I to III
* Scheduled for elective video-assisted thoracoscopic surgery including wedge resection, segmentectomy, or lobectomy

Exclusion Criteria:

* Refusal to participate
* Pregnancy
* Morbid obesity (body mass index greater than 40 kg per square meter)
* Allergy to opioids, local anesthetics, or nonsteroidal anti-inflammatory drugs
* Neuropsychiatric disorders, cognitive impairment, or inability to communicate
* History of substance abuse
* Use of anticoagulant therapy or presence of bleeding disorders
* Active systemic infection
* Severe cardiovascular, hepatic, renal, or endocrine disease
* Chronic pain syndrome or ongoing chronic pain treatment
* Emergency surgery or prior ipsilateral thoracic surgery
* Preoperative opioid use
* Significant intraoperative or postoperative bleeding or hemodynamic instability
* Requirement for prolonged postoperative mechanical ventilation longer than 18 hours

Where this trial is running

Atakent, Samsun

Study contacts

How to participate

  1. Review the eligibility criteria above with your treating physician.
  2. Visit the official trial page on ClinicalTrials.gov for the most current contact information and recruitment status.
  3. Contact the listed study coordinator or principal investigator to request pre-screening. Pre-screening is free and never obligates you to enroll.

View on ClinicalTrials.gov →

Conditions: Thoracic Anesthesia, Postoperative Pain, Video Assisted Thoracic Surgery, Thoracic Surgery, Video-Assisted, Analgesia, Postoperative, Morphine, Injections, Spinal, Nerve Block

Last reviewed 2026-05-15 by the Find a Trial editorial team. Information on this page is for educational purposes and is not medical advice. Always consult qualified healthcare professionals about clinical trial participation.