Pain Control and Recovery After Thoracic Surgery Using SPSIP Block

Thoracic surgery is frequently associated with significant postoperative pain, which may impair respiratory function, mobilization, recovery, and patient satisfaction. The Serratus Posterior Superior Intercostal Plane (SPSIP) block is a recently described ultrasound-guided fascial plane block that may provide effective analgesia after thoracic surgery. This prospective observational cohort study will evaluate the analgesic effectiveness and postoperative recovery associated with SPSIP block in adult patients undergoing elective minor video-assisted thoracoscopic surgery (VATS), major VATS, or thoracotomy. All patients will receive SPSIP block as part of routine institutional multimodal analgesia. The primary outcome will be postoperative quality of recovery assessed using the Quality of Recovery-15 (QoR-15) questionnaire at 24 hours after surgery. Secondary outcomes will include postoperative pain intensity, opioid consumption, rescue analgesic requirements, postoperative nausea and vomiting, pulmonary complications, patient satisfaction, length of hospital stay, and chronic postoperative pain.

Inclusion Criteria: * Age 18 years or older * American Society of Anesthesiologists (ASA) physical status I-III * Scheduled for elective thoracic surgery * Undergoing minor video-assisted thoracoscopic surgery (VATS), major VATS, or thoracotomy * Planned ultrasound-guided Serratus Posterior Superior Intercostal Plane (SPSIP) block as part of routine multimodal analgesia * Able and willing to provide written informed consent Exclusion Criteria: * Patient refusal * Known allergy to amide local anesthetics * Coagulopathy * Therapeutic anticoagulation incompatible with regional anesthesia * Infection at the planned block injection site * Pregnancy * Emergency surgery * Chronic opioid therapy for more than 3 months * Chronic pain syndrome * Cognitive impairment that prevents reliable study assessments * Inability to complete the Quality of Recovery-15 (QoR-15) questionnaire