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Background and Aims Median sternotomy is the traditional method for cardiac surgery. It comes with drawbacks like intense pain, extended hospitalization, and aesthetic issues. Minimally invasive cardiac surgery (MCIS) avoids these disadvantages, enabling faster recovery after surgery. Patients might still experience significant pain due to the involvement of intercostal nerves and rib retraction. The serratus posterior superior intercostal plane block (SPSIPB) is a new technique performed between the serratus posterior superior muscle and the intercostal muscles. We wanted to share our experience with SPSIPBs for MICS in four patients. All patients provided written informed consent.

Methods The patients’ demographics were as follows: male aged 53 years (Patient 1), female aged 35 years (Patient 2), female aged 74 years (Patient 3) and male aged 38 years (Patient 4). Before induction of anesthesia, each patient had SPSIPB applied in the sitting position. After proper placement of the block needle between the third rib and the serratus posterior superior muscle, 40 ml of 0.25% bupivacaine was delivered.

Results The patients were transferred to the cardiovascular intensive care unit after surgery and were attached to a patient-controlled analgesia device containing morphine. Pain was evaluated using the numerical rating scale (NRS). The NRS scores at extubation time, 1, 6, 12, and 24 h were recorded.

Conclusions We assessed the effectiveness of SPSIPB in patients who had MICS. SPSIPB may offer effective pain management following MICS. Randomized controlled trials are needed to determine the feasibility of SPSIPB more accurately.