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Serratus posterior superior intercostal plane block (SPSIPB) reduces perioperative pain and improves postoperative sleep quality in patients undergoing cardiac implantable electronic device implantation.

In a double-blind RCT of 60 patients, SPSIPB significantly reduced pain scores at all time points compared to sham control (p < 0.001), with clinically significant intraoperative pain (VAS ≥ 4) occurring in 83.3% of controls versus none in the SPSIPB group. Postoperative sleep quality was also improved, with median SQ-NRS scores of 2 in the SPSIPB group versus 7 in controls (p < 0.001), and 80.0% of controls reporting poor sleep quality versus none in the SPSIPB group.

Last updated: Jul 30, 2026•1 RCTs•📖 Read as article →

Evidence Score

Evidence Score42/100
Human RCT★★☆☆☆
Meta-analysis☆☆☆☆☆
Mechanism★★★★★
Safety★★★★☆
Confidencelow

Study Evidence

Study 1. Efficacy of Serratus Posterior Superior Intercostal Plane Block (SPSIPB) in Cardiac Implantable Electronic Device Implantation (CIED): A Prospective, Double-Blind, Randomized Controlled Trial.

observational

Altun G, Esin A, Ozsahin Y, Arslan S, Bilgin ME, Sandal B, Erkalp K, Salihoglu Z · Journal of clinical medicine (2026)

Participants: N/A
Duration: 24 hours
Intervention: Ultrasound-guided serratus posterior superior intercostal plane block (SPSIPB) administered preoperatively
Outcome: Perioperative pain intensity (Visual Analog Scale), postoperative sleep quality (Sleep Quality Numeric Rating Scale), patient and physician satisfaction (Likert scale)
Effect Size: N/A
Population: 60 patients undergoing primary cardiac implantable electronic device (CIED) implantation

Result:

PubMed: 42513545DOI: 10.3390/jcm15145629

Mechanism Graph

Local anesthetic injected into the serratus posterior superior intercostal plane
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Blocks sensory innervation from the posterior rami of thoracic spinal nerves
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Reduces nociceptive input during and after CIED implantation
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Result: Lower perioperative pain scores and improved sleep quality

Limitations

  • ⚠Secondary outcomes (sleep quality, satisfaction) were exploratory and not powered for definitive conclusions
  • ⚠Single-center trial with small sample size (n=60) limits generalizability

Frequently Asked Questions

What is SPSIPB?▼

Serratus posterior superior intercostal plane block is an ultrasound-guided regional anesthesia technique that targets the plane deep to the serratus posterior superior muscle to provide analgesia for chest wall procedures.

How was sleep quality measured in this study?▼

Sleep quality was assessed using the Sleep Quality Numeric Rating Scale (SQ-NRS), a 0-10 scale where higher scores indicate worse sleep quality.

Did SPSIPB reduce the need for rescue pain medication?▼

Yes, the abstract notes reduced rescue analgesic requirements during the first 24 hours after CIED implantation in the SPSIPB group.

Is SPSIPB safe for all CIED patients?▼

This study included only primary CIED implantations; safety in other populations or procedures requires further research.

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References

  1. 1.Altun G, Esin A, Ozsahin Y, Arslan S, Bilgin ME, Sandal B, Erkalp K, Salihoglu Z. "Efficacy of Serratus Posterior Superior Intercostal Plane Block (SPSIPB) in Cardiac Implantable Electronic Device Implantation (CIED): A Prospective, Double-Blind, Randomized Controlled Trial.." Journal of clinical medicine, 2026. PMID: 42513545 DOI: 10.3390/jcm15145629
Disclaimer: This content is for educational purposes only and is not medical advice. Evidence scores reflect the quality and quantity of available research, not clinical recommendations. Always consult a healthcare professional before starting any supplement or intervention.