RISS Block for Enhanced Recovery After Video-Assisted Thoracoscopic Surgery

NCT07462273 — Not applicable, Completed, 90 participants, Ningbo University

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A Prospective Randomized Controlled Trial Evaluating the Efficacy and Safety of Ultrasound-Guided Rhomboid Intercostal and Subserratus Plane Block for Enhanced Recovery After Video-Assisted Thoracoscopic Surgery

Registry	NCT07462273
Status	Completed
Phase	Not applicable
Study type	Interventional; randomized, parallel, masking: double, treatment
Enrollment	90 (Actual)
Sponsor	Ningbo University (Other)
Conditions	Postoperative Pain, Thoracic Surgery, Video-Assisted Thoracic Surgery
Interventions	Rhomboid Intercostal and Subserratus Plane Block with local anesthetic, Intercostal nerve block (Procedure)
Dates	start 2024-09-01, primary completion 2025-09-01, completion 2025-10-01, first posted 2026-03-10, last updated 2026-03-10
Locations	1 site in China

-Summary

This prospective randomized controlled trial evaluates the efficacy and safety of ultrasound-guided rhomboid intercostal and subserratus plane (RISS) block for postoperative analgesia in patients undergoing video-assisted thoracoscopic surgery (VATS).

Postoperative pain after VATS can impair respiratory function, delay mobilization, and increase opioid consumption. Although several regional anesthesia techniques are available, the optimal analgesic strategy remains under investigation. The RISS block is a novel fascial plane block that may provide effective thoracic analgesia while minimizing opioid-related adverse effects.

A total of 90 adult patients scheduled for elective VATS will be randomly assigned to receive either ultrasound-guided RISS block combined with general anesthesia or general anesthesia alone. The primary outcomes include postoperative 24-hour benefit of analgesia score (BCS) and patient-controlled intravenous analgesia (PCIA) pressing frequency. Secondary outcomes include postoperative pain scores, opioid consumption, and adverse events.

This study aims to determine whether RISS block improves postoperative recovery and reduces opioid requirements after VATS.

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+Arms and interventions

Arm	Type	Interventions
RISS Block Group	Experimental	Procedure: Rhomboid Intercostal and Subserratus Plane Block with local anesthetic
ICNB Group	Experimental	Procedure: Intercostal nerve block
Control Group	No intervention

Rhomboid Intercostal and Subserratus Plane Block with local anesthetic (Procedure): Ultrasound-guided dual-plane RISS block performed after induction of general anesthesia. A total of 40 mL of 0.375% ropivacaine (150 mg) was administered across the rhomboid-intercostal plane and low subserratus plane.
Intercostal nerve block (Procedure): Ultrasound-guided intercostal nerve block performed at surgical port levels (T4-T7) using 0.375% ropivacaine with total dose ≤75 mg.

+Outcome measures

Primary outcomes

24-hour cumulative number of effective PCA presses [Within 24 hours postoperatively]
Bruggrmann Comfort Scale (BCS) score at 24 hours [24 hours after surgery]

+Eligibility

Sex: All, ages: 18 Years to any

Inclusion Criteria:

Adults aged 18 years or older

ASA physical status I-II

Scheduled for elective video-assisted thoracoscopic surgery (VATS)

Provided written informed consent

Exclusion Criteria:

History of shock or coma

Coagulopathy

Local infection at the puncture site

Pre-existing nerve injury on the side intended for block

Chronic analgesic use

Psychiatric disorders

Prior thoracic or breast surgery

Allergy to local or general anaesthetic agents

Body mass index (BMI) ≥35 kg/m²

Inability to operate a patient-controlled analgesia (PCA) device

+Locations (1)

Facility	City	Country	Status
The Affiliated Hospital of Ningbo University	Ningbo	China