Serratus Posterior Superior Intercostal Plane Block During Port Catheter Implantation: A Prospective Randomized Controlled Trial

Objectives: Port catheter implantation is a commonly performed minimally invasive procedure that may still cause intraoperative discomfort and require supplemental analgesia. The serratus posterior superior intercostal plane (SPSIP) block is a recently described regional anesthesia technique for thoracic analgesia. This study evaluated the analgesic efficacy of the SPSIP block during port catheter implantation.
Methods: In this prospective randomized study, 66 patients undergoing elective port catheter implantation were allocated to either the SPSIP block group (n=33) or the local infiltration (LI) group (n=33). The primary outcome was pain intensity during port pocket creation, measured using the Numeric Rating Scale (NRS). Secondary outcomes included maximum intraoperative pain score, supplemental local anesthetic requirement, total tramadol consumption within the first 24 hours, patient and surgeon satisfaction, and procedure-related complications.
Results: Pain intensity during port pocket creation was significantly lower in the SPSIP group than in the LI group (median [IQR]: 1 [1–2] vs. 2 [1–3]; p=0.038). Maximum intraoperative pain scores and supplemental local anesthetic requirements were also significantly lower in the SPSIP group (p=0.038 and p=0.014, respectively). Although 24-hour tramadol consumption was lower in the SPSIP group, the difference was not statistically significant (p=0.154). Patient and surgeon satisfaction scores were significantly higher in the SPSIP group (p=0.026 and p=0.002, respectively).
Conclusion: The SPSIP block provides effective intraoperative analgesia during port catheter implantation, reduces supplemental local anesthetic requirements, and improves patient and surgeon satisfaction.

Keywords: Analgesia, port catheter implantation, regional anesthesia, serratus posterior superior intercostal plane block