SPSIPB Versus Deep SAPB for Analgesia After Breast Surgery

Comparison of Serratus Posterior Superior Intercostal Plane Block Versus Deep Serratus Anterior Plane Block for Postoperative Analgesia After Breast Surgery: a Prospective Randomized Study

The application of regional anaesthetic procedures in breast surgery is associated with a lower incidence of chronic pain, reduced morbidity, shorter hospital stay and less opioid requirement. Therefore, we aimed to compared the postoperative analgesic efficacy of Serratus Anterior Plan Block and Serratus Posterior Superior Intercostal Plan Block in breast surgery.

Study Overview

• Status: Completed
• Conditions: Analgesia
• Intervention / Treatment: Other: plane block with %0.25 30 ml bupivacaine

Detailed Description

Breast surgery is one of the most common operations performed by General Surgery and may be associated with acute postoperative pain. Acute postoperative pain is an independent risk factor for the development of chronic pain after mastectomy. Various regional anaesthetic procedures have been tried to achieve better acute pain control and thus less chronic pain. The use of regional anaesthetic procedures in breast surgery is associated with a lower incidence of chronic pain, reduced morbidity, shorter hospital stay and less opioid requirement.

Interfascial plane blocks have become popular because they are easy to perform and safe. Since interfascial plan blocks are based on the injection of local anaesthetic between two fasciae, the complication rate such as nerve damage is very low. With this method, effective analgesia can be provided in various areas such as abdominal, thoracic and lumbar regions while reducing opioid consumption and avoiding neuraxial methods.

In randomised controlled trials investigating the efficacy of Serratus Anterior Plane Block for postoperative analgesia management after breast surgery, adequate analgesia was reported.

Serratus posterior superior intercostal plan block, a newly defined interfascial plan block, has been shown to provide a wide sensory blockade between intercostal muscles. Postoperative analgesic efficacy has been demonstrated in thoracic, breast and shoulder surgeries.

The aim of our study was to compared the postoperative analgesic efficacy of Serratus Anterior Plan Block and Serratus Posterior Superior Intercostal Plan Block in breast surgery.

• Study Type: Interventional
• Enrollment (Actual): 62
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Turkey (Türkiye)
  • Istanbul, Turkey (Türkiye)
    • Istanbul Professor Doctor Süleyman Yalçın City Hospital

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: Yes

Description

Inclusion Criteria:

• unilateral mastectomy(modified radial mastectomy)
• ASA I-III risk group

Exclusion Criteria:

• Coagulopathy
• Wound and infection in the block area
• Local anaesthetic allergy
• Mental retardation
• Non-cooperative
• Pregnant patients

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Supportive Care
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Single

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Active Comparator: Patients with serratus posterior superior intercostal plan block; Serratus posterior superior intercostal plane block was applied to a certain group of patients for postoperative analgesia	Other: plane block with %0.25 30 ml bupivacaine; evaluation of the efficacy of two different plan blocks for postoperative analgesia; Other Names: postoperative analgesia
Active Comparator: Patients with serratus anterior plan block; Serratus anterior plane block was applied to a certain group of patients for postoperative analgesia	Other: plane block with %0.25 30 ml bupivacaine; evaluation of the efficacy of two different plan blocks for postoperative analgesia; Other Names: postoperative analgesia

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Evaluation of analgesic efficacy of postoperative plan blocks with numerical pain score (NRS)	Evaluation of which of the two plan blocks is more effective in postoperative analgesia. Postoperative pain scores will be evaluated with a numerical pain score. Evaluation will be performed postoperatively at 1. hour, 4. hours, 8. hours, 12. hours and 24. hours. A lower numeric pain scale indicates a lower level of pain.	within 24 hours postoperative

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
rescue anesthesia	In the postoperative 24-hour period, tenoxicam will be administered and recorded as rescue analgesia to patients who feel pain despite patient-controlled nalgesia (tramadol).	within 24 hours postoperative
postoperative nausea-vomiting (PONV)	The number of times of nausea and vomiting in the postoperative period will be recorded and compared in both patient groups. A lower numerical value of postoperative nausea-vomiting indicates better patient comfort in the postoperative period.	within 24 hours postoperative
perioperative remifentanil consumption	The amounts (mcg) of remifantanil consumed during the surgical procedure will be compared	perioperative
Comparison of tramadol(mg) consumption	Using a patient-controlled analgesia device, tramadol consumption and total tramadol consumption will be compared between 0-1st hour, 1st-4th hour, 4th-8th hour, 8th-12th hour, 12th-24th hour postoperatively..	within 24 hours postoperative
patient satisfaction (5-point Likert scale)	At postoperative discharge, 5-point Likert satisfaction questionnaire will be administered to the patient. A high numerical value on a five-point Likert satisfaction scale indicates that the patient are satisfied with the procedure performed.	24 hours after surgery

Collaborators and Investigators

• Sponsor: Mustafa Burgac

Study record dates

Study Major Dates

• Study Start (Actual): December 13, 2023
• Primary Completion (Actual): June 30, 2024
• Study Completion (Actual): June 30, 2024

Study Registration Dates

• First Submitted: May 22, 2024
• First Submitted That Met QC Criteria: May 28, 2024
• First Posted (Actual): May 31, 2024

Study Record Updates

• Last Update Posted (Actual): May 19, 2026
• Last Update Submitted That Met QC Criteria: May 16, 2026
• Last Verified: May 1, 2026

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Neurologic Manifestations; Nervous System Diseases; Neurobehavioral Manifestations; Perceptual Disorders; Pathological Conditions, Signs and Symptoms; Signs and Symptoms; Agnosia; Organic Chemicals; Anilides; Amides; Aniline Compounds; Amines; Bupivacaine
• Other Study ID Numbers: 2023/0870

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No