Comparison of Combined (Superficial and Deep) and Isolated Deep Serratus Anterior Plane Blocks After Breast Surgery

Investigation of the Effectiveness of Ultrasonography-Guided Deep Serratus Anterior Plane Block and Combined Superficial and Deep Serratus Anterior Plane Block on Postoperative Pain in Patients Undergoing Modified Radical Mastectomy and Breast-Conserving Surgery

The main purpose of this study is to compare the effectiveness of two different regional anesthesia techniques for pain management after oncological breast surgeries. The researchers will compare the combined (superficial and deep) serratus anterior plane block with the deep serratus anterior plane block. The study aims to evaluate which method provides better postoperative pain relief, reduces the total consumption of opioid analgesics, and improves patient comfort

Study Overview

• Status: Completed
• Conditions: Breast Cancer; Postoperative Pain; Pain Management After Surgery

• Study Type: Observational
• Enrollment (Actual): 76

Contacts and Locations

Study Locations

• Turkey (Türkiye)
  • Ankara
    • Altındağ, Ankara, Turkey (Türkiye), 00000
      • Ankara Training and Research Hospital

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

• Sampling Method: Non-Probability Sample

Study Population

Patients undergoing elective modified radical mastectomy or breast-conserving surgery at SBU Ankara Egitim ve Arastirma Hastanesi

Description

Inclusion Criteria:

Patients aged 18-80 years.

Female patients with ASA physical status I, II, or III.

Patients scheduled for elective modified radical mastectomy or breast-conserving surgery.

Patients who provided written and verbal informed consent.

Exclusion Criteria:

Patients with ASA physical status IV-V.

Patients with a BMI ≥ 35 kg/m².

Patients with chronic pain, opioid/substance addiction, or long-term analgesic use.

Patients requiring emergency surgery.

Pregnant patients.

Known allergy to local anesthetics.

Severe cardiovascular, cerebrovascular, liver, or renal disease.

History of coagulopathy.

Infection at the injection site or systemic infection.

Patients who refuse the regional anesthesia technique, cannot speak the official language, or have mental disabilities/inability to cooperate.

Patients with a history of previous breast surgery or those scheduled for bilateral operations.

Study Plan

How is the study designed?

Number of groups / cohorts

2

Cohorts and Interventions

Group / Cohort
Combined Serratus Anterior Plane Block Group; Patients receiving both superficial and deep serratus anterior plane block
Isolated Deep Serratus Anterior Plane Block Group; Patients receiving only deep serratus anterior plane block

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Visual Analog Scale (VAS) Scores for Postoperative Pain	Assessment of postoperative pain using the Visual Analog Scale (VAS) (minimum score: 0, maximum score: 10, where higher scores indicate worse outcome).	Postoperative 24 hours.

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Total Tramadol Consumption	Total amount of tramadol consumed by the patient as rescue analgesia.	Postoperative 24 hours.
Need for rescue analgesia	Requirement for additional analgesic medications beyond the standard protocol.	Postoperative 24 hours.
Time to first rescue analgesia	Time elapsed from the end of surgery until the first request for rescue analgesia.	Postoperative 24 hours.
Postoperative nausea and vomiting (PONV) scores	Assessment of postoperative nausea and vomiting severity.	Postoperative 24 hours.
Patient satisfaction	Patient satisfaction level regarding the pain management technique.	Postoperative 24 hours.
Block-related complications	Incidence of potential complications related to the block technique (e.g., hematoma, infection, local anesthetic toxicity).	Postoperative 24 hours.

Collaborators and Investigators

• Sponsor: SBU Ankara Egitim ve Arastirma Hastanesi
• Investigators: Study Director: Meltem Bektas, Associate Professor, SBU Ankara Egitim ve Arastirma Hastanesi; Principal Investigator: Dilara Hatice Arican, MD, SBU Ankara Egitim ve Arastirma Hastanesi

Study record dates

Study Major Dates

• Study Start (Actual): April 21, 2025
• Primary Completion (Actual): January 28, 2026
• Study Completion (Actual): May 18, 2026

Study Registration Dates

• First Submitted: July 17, 2026
• First Submitted That Met QC Criteria: July 21, 2026
• First Posted (Actual): July 24, 2026

Study Record Updates

• Last Update Posted (Actual): July 24, 2026
• Last Update Submitted That Met QC Criteria: July 21, 2026
• Last Verified: July 1, 2026

More Information

Terms related to this study

• Keywords: Analgesia; Bupivacaine; Regional Anesthesia; Breast Surgery; Serratus Anterior Plane Block
• Additional Relevant MeSH Terms: Pain; Neurologic Manifestations; Nervous System Diseases; Postoperative Complications; Pathologic Processes; Neoplasms by Site; Neoplasms; Neurobehavioral Manifestations; Skin Diseases; Breast Diseases; Perceptual Disorders; Pathological Conditions, Signs and Symptoms; Skin and Connective Tissue Diseases; Signs and Symptoms; Pain, Postoperative; Breast Neoplasms; Agnosia
• Other Study ID Numbers: E.25/447

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