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Minimum Effective Volume of Bupivacaine for Serratus Posterior Superior Intercostal Plane Block in Video-Assisted Thoracoscopic Surgery
Sponsor: Bursa City Hospital
Summary
This study determined the median effective volume (EV50) of bupivacaine required for the serratus posterior superior intercostal plane (SPSIP) block in patients undergoing video-assisted thoracoscopic surgery (VATS). The SPSIP block is an ultrasound-guided regional anesthesia technique used to provide postoperative pain relief after thoracic surgery. All patients received bupivacaine at a final concentration of 0.25%, prepared by diluting the commercially available 0.5% preparation 1:1 with 0.9% sodium chloride. Using a sequential up-and-down dose-adjustment method, the volume of local anesthetic was increased or decreased according to the block outcome of the preceding patient. The main outcome of the study was the volume that provided an effective block in 50% of patients. EV50 is not a recommended clinical dose; the results are intended to inform future studies targeting higher effective percentiles.
Official title: Determination of the Median Effective Volume (ED50) of Bupivacaine for Serratus Posterior Superior Intercostal Plane Block in Patients Undergoing Video-Assisted Thoracoscopic Surgery Using the Dixon Up-and-Down Method
Key Details
Gender
All
Age Range
18 Years - Any
Study Type
INTERVENTIONAL
Enrollment
27
Start Date
2026-03-15
Completion Date
2026-07-15
Last Updated
2026-09-24
Healthy Volunteers
No
Interventions
Ultrasound-Guided Serratus Posterior Superior Intercostal Plane Block
Ultrasound-guided serratus posterior superior intercostal plane block performed before induction of general anesthesia in patients undergoing video-assisted thoracoscopic surgery (VATS). With the patient seated, a high-frequency linear probe was placed in the sagittal plane over the superior angle of the scapula, and the needle was advanced in-plane until its tip lay between the serratus posterior superior muscle and the third rib. Bupivacaine 0.25%, prepared by 1:1 dilution of the 0.5% commercial preparation with 0.9% sodium chloride, was injected in 5 mL aliquots with intermittent aspiration after hydrodissection with 1 mL of saline. The injected volume was adjusted in 2 mL increments according to the Dixon up-and-down sequential allocation method to determine the median effective volume (EV50). The 0.5% descriptor refers to the commercial preparation only; all participants received bupivacaine at a final concentration of 0.25%.
Locations (1)
T.C. Sağlık Bakanlığı Bursa Şehir Hastanesi
Nilufer, Bursa, Turkey (Türkiye)