Analgesic Efficiency of SIPSPB vs ICNB in VATS Surgery

In our prospective observational study, patients included in the study will receive Serratus Posterior Superior Intercostal Plane (SPSIP) block and Intercostal Nerve (ICN) block for postoperative analgesia at the end of surgery. The SPSIP block will be performed by the anesthesiologist under ultrasound guidance immediately after skin closure and before extubation, while the ICN block will be performed by the surgeon under direct vision immediately before skin closure. Patients will receive 1000 mg paracetamol and 50 mg dexketoprofen at the end of surgery, during skin closure. Upon arrival in the recovery room, each patient will be connected to a patient-controlled analgesia (PCA) pump containing tramadol. At postoperative reassessment, patients with a Numerical Pain Rating Scale (NPRS) score greater than 4, despite PCA use, will receive a rescue analgesic dose of 50 mg dexketoprofen. Postoperative pain intensity will be assessed using NPRS (Numeric pain rating scale) at 1, 4, 6, 12, 18, and 24 hours postoperatively, both at rest and during coughing. Total opioid consumption, rescue analgesic use, and postoperative complications will be recorded. Patients will be asked about their level of surgical satisfaction 24 hours after surgery, and this information will be recorded.