Serratus Posterior Superior Intercostal Plane Block in Minimally Invasive Cardiac Surgery

This randomized, double-blind, placebo-controlled study aims to evaluate the effect of the serratus posterior superior intercostal plane (SPSIP) block on postoperative pain and opioid consumption in patients undergoing minimally invasive cardiac valve surgery via mini-thoracotomy.

Inclusion Criteria: * Adult patients aged 18-75 years * ASA physical status I-III * Scheduled for elective minimally invasive cardiac valve surgery via mini-thoracotomy * Able to understand and use the Numeric Rating Scale (NRS) * Provided written informed consent Exclusion Criteria: * Age \>75 years * Known allergy or hypersensitivity to local anesthetics (e.g., bupivacaine) * Coagulopathy or ongoing anticoagulant therapy that cannot be discontinued * Infection at the planned block site * Chronic opioid use or chronic pain conditions * Severe pulmonary disease affecting respiratory assessment * Neurological or psychiatric disorders interfering with pain assessment * Emergency surgery * Pregnancy or breastfeeding * Refusal to participate