Comparative Sensory Mapping of Regional Anesthesia Techniques in Breast Cancer Surgery

November 21, 2025 updated by: Samsun University

Cutaneous Sensory Mapping and Comparative Analysis of Different Regional Anesthesia Techniques in Breast Cancer Surgeries: A Prospective Observational Study

Various regional anesthesia techniques, either individually or in combination, can be utilized for analgesia in breast cancer surgery. This study aims to map the cutaneous sensory block areas of different regional anesthesia techniques (serratus anterior plane block, parasternal block, and interpectoral + pectoserratus plane block) applied to patients undergoing breast cancer surgery. Furthermore, the extent to which these blocks cover the modified radical mastectomy incision will be assessed. The study seeks to comparatively determine the minimum and maximum sensory spread of each block. Ultimately, the findings are intended to provide valuable data for developing tailored perioperative pain management strategies specific to the surgical procedure and individual patient needs.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

Breast cancer is the most common type of cancer in women, and surgical intervention is frequently employed as a treatment modality. However, the choice of surgical approach may vary depending on the tumor subtype and the extent of metastasis. The orientation of the surgical incision also differs based on the tumor location and/or the presence of axillary involvement.

Accurately identifying the anatomical location of the affected tissues during breast surgery is of critical importance for planning an effective perioperative analgesia strategy. Procedures such as lumpectomy, partial mastectomy, and therapeutic mammoplasty primarily involve the skin and subcutaneous breast tissue. Depending on whether the surgery is performed medial or lateral to the nipple, the anterior or lateral cutaneous branches of the intercostal nerves play a role in innervating the surgical area. In more extensive surgeries such as modified radical mastectomy (MRM), nerves originating from the brachial plexus (pectoralis, thoracodorsal, and long thoracic nerves) may contribute to perioperative pain. These procedures typically involve the dissection of all subcutaneous breast tissue, the overlying skin, and the pectoralis and serratus anterior muscles and often necessitate sentinel lymph node biopsy or axillary dissection.

Due to these factors, various incision types are used in oncological breast surgeries depending on the type of surgery. Therefore, a patient-specific perioperative pain protocol should be established for each procedure, and the most appropriate regional anesthesia technique should be selected accordingly.

In the literature, serratus plane blocks, paravertebral block, interpectoral, and pectoserratus blocks, as well as their combination, have been reported to provide effective perioperative pain management in breast cancer surgery. These techniques offer benefits such as reducing acute and chronic pain, minimizing the surgical stress response, facilitating early mobilization, decreasing opioid consumption, and ensuring a more hemodynamically stable perioperative period.

In the investigators' clinic, regional anesthesia techniques guided by ultrasound are routinely administered, either alone or in combination, to manage perioperative pain in patients undergoing breast cancer surgery. These techniques include serratus anterior plane block, parasternal block, and interpectoral + pectoserratus plane block.

The study was designed as an observational clinical trial to evaluate patients undergoing breast cancer surgery who received regional anesthesia for perioperative pain management. The primary objective is to evaluate the cutaneous sensory block areas of these blocks and compare the blocked sensory areas with the modified radical mastectomy incision to assess the minimum and maximum sensory spread of each block.

Study Type

Observational

Enrollment (Actual)

36

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • Turkey (Türkiye)
    • Ilkadim
      • Samsun, Ilkadim, Turkey (Türkiye), 55400
        • Samsun University, Samsun Training and Research Hospital

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Sampling Method

Non-Probability Sample

Study Population

Patients scheduled for breast cancer surgery and receiving regional anesthesia as part of their perioperative analgesia management will be included in the study.

Description

Inclusion Criteria:

  • Patients with unilateral breast cancer surgery
  • Patients receiving regional anesthesia as part of their perioperative analgesia management
  • Aged between 18 and 70 years.
  • ASA<IV
  • Patients who agree to participate and provide written informed consent

Exclusion Criteria:

  • Patients who refuse to participate.
  • Patients who have not undergone any regional anesthesia technique.
  • ASA>III
  • Bilateral mastectomy.
  • History of previous breast surgery (except excisional biopsy).
  • Cognitive impairment or dementia.
  • Patients with psychiatric disorders such as depression, mania, or schizophrenia.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

Cohorts and Interventions

Group / Cohort
Intervention / Treatment
Group Serratus Anterior Plane Block
Patients who received ultrasound-guided Serratus Anterior Plane Block during the preoperative period.
Other: Group Serratus Anterior Plane Block
Patients will receive a serratus anterior plane block preoperatively under ultrasound guidance. Thirty minutes after the block, the cutaneous sensory area will be assessed using a pinprick test and outlined on the skin using a UV marker. Subsequently, the incision line for the modified radical mastectomy (MRM) will be marked by the operating surgeon. The resulting drawings will be documented and transferred to a digital template for analysis.
Group Parasternal Block
Patients who received ultrasound-guided Parasternal Block during the preoperative period.
Other: Group Parasternal Block
Patients will receive a parasternal block preoperatively under ultrasound guidance. Thirty minutes after the block, the cutaneous sensory area will be assessed using a pinprick test and outlined on the skin using a UV marker. Subsequently, the incision line for the modified radical mastectomy (MRM) will be marked by the operating surgeon. The resulting drawings will be documented and transferred to a digital template for analysis.
Group Interpectoral+Pectoserratus Plane Block
Patients who received ultrasound-guided Interpectoral+Pectoserratus Plane Block during the preoperative period.
Other: Group Interpectoral+Pectoserratus Plane Block

Patients will receive an interpectoral + pectoserratus plane block preoperatively under ultrasound guidance.

Thirty minutes after the block, the cutaneous sensory area will be assessed using a pinprick test and outlined on the skin using a UV marker. Subsequently, the incision line for the modified radical mastectomy (MRM) will be marked by the operating surgeon. The resulting drawings will be documented and transferred to a digital template for analysis.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Cutaneous sensory block area mapping for different regional anesthesia techniques in breast cancer surgery
Time Frame: At 30 minutes after the regional anesthesia and before surgery
The cutaneous sensory block area resulting from the regional anesthesia technique applied to each patient will be assessed using a pinprick test at the 30th minute post-block. These areas will be delineated and mapped using a UV marker, and the data collected for each group will be processed to generate a density map using the digital template.
At 30 minutes after the regional anesthesia and before surgery

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Determination of the minimum and maximum spread of each block technique in relation to the modified radical mastectomy (MRM) incision
Time Frame: At 30 minutes after the regional anesthesia and before surgery
The cutaneous sensory block area following the regional anesthesia technique will be compared with the modified radical mastectomy (MRM) incision indicated by the surgeon on the patient. The images will be documented and analyzed with digital template. Areas that correspond (either fully or partially) with the incision line will be identified. For each block technique, the minimum and maximum spread of the modified radical mastectomy (MRM) incision will be determined and compared.
At 30 minutes after the regional anesthesia and before surgery

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Samsun University

Investigators

  • Study Director: Caner Genc, M.D., Samsun University

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

April 14, 2025

Primary Completion (Actual)

October 14, 2025

Study Completion (Actual)

October 24, 2025

Study Registration Dates

First Submitted

March 28, 2025

First Submitted That Met QC Criteria

March 28, 2025

First Posted (Actual)

April 4, 2025

Study Record Updates

Last Update Posted (Actual)

November 24, 2025

Last Update Submitted That Met QC Criteria

November 21, 2025

Last Verified

November 1, 2025

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • GOKAEK 2025/6/11

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

UNDECIDED

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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