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RISS Versus SPSIP Block in Modified Radical Mastectomy (RSMRM)

19. juni 2026 opdateret af: Ferit Yetik

Comparison of Rhomboid Intercostal-Subserratus Plane Block and Serratus Posterior Superior Intercostal Plane Block for Postoperative Analgesia and Dermatomal Spread After Modified Radical Mastectomy: A Randomized Double-Blind Trial

This prospective randomized double-blind controlled trial aims to compare the postoperative analgesic efficacy and dermatomal spread of rhomboid intercostal-subserratus plane (RISS) block and serratus posterior superior intercostal plane (SPSIP) block in patients undergoing modified radical mastectomy. Postoperative pain scores, opioid consumption, rescue analgesic requirements, block-related complications, and quality of recovery outcomes will be evaluated.

Studieoversigt

Status

Rekruttering

Betingelser

Intervention / Behandling

Detaljeret beskrivelse

Breast cancer surgery is frequently associated with moderate to severe postoperative pain, which may negatively affect recovery and increase opioid consumption. Ultrasound-guided fascial plane blocks have become an important component of multimodal analgesia strategies for breast surgery.

The rhomboid intercostal-subserratus plane (RISS) block and serratus posterior superior intercostal plane (SPSIP) block are recently described regional anesthesia techniques that may provide effective postoperative analgesia by blocking the lateral and posterior branches of the thoracic spinal nerves. However, comparative clinical evidence regarding their analgesic efficacy and dermatomal coverage in modified radical mastectomy remains limited.

This prospective randomized double-blind controlled trial will compare RISS block and SPSIP block in adult patients undergoing modified radical mastectomy under general anesthesia. Participants will be randomly allocated to receive either RISS block or SPSIP block before surgery. The primary objective is to compare postoperative opioid consumption. Secondary outcomes include postoperative pain scores, dermatomal sensory spread, time to first rescue analgesia, quality of recovery, opioid-related adverse events, and block-related complications.

Undersøgelsestype

Interventionel

Tilmelding (Anslået)

80

Fase

  • Ikke anvendelig

Kontakter og lokationer

Dette afsnit indeholder kontaktoplysninger for dem, der udfører undersøgelsen, og oplysninger om, hvor denne undersøgelse udføres.

Studiekontakt

Studiesteder

Deltagelseskriterier

Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.

Berettigelseskriterier

Aldre berettiget til at studere

  • Voksen
  • Ældre voksen

Tager imod sunde frivillige

Ingen

Beskrivelse

Inclusion Criteria:

  • Female patients aged 18-75 years
  • ASA physical status I-III
  • Scheduled for elective unilateral modified radical mastectomy with axillary dissection under general anesthesia
  • Provision of written informed consent

Exclusion Criteria:

  • Anticoagulant therapy
  • Bleeding diathesis
  • Known allergy to local anesthetics or opioids
  • Infection at the block application site or previous surgery in the block area
  • Cognitive impairment preventing NRS assessment
  • Pregnancy or lactation
  • Chronic opioid use
  • Severe hepatic or renal failure
  • Refusal to participate in the study
  • Technical inability to perform the block or failed block

Studieplan

Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

  • Primært formål: Behandling
  • Tildeling: Randomiseret
  • Interventionel model: Parallel tildeling
  • Maskning: Tredobbelt

Våben og indgreb

Deltagergruppe / Arm
Intervention / Behandling
Eksperimentel: RISS Block
Patients will receive an ultrasound-guided rhomboid intercostal-subserratus plane (RISS) block before modified radical mastectomy for postoperative analgesia.
Procedure: Rhomboid Intercostal-Subserratus Plane Block
Ultrasound-guided rhomboid intercostal-subserratus plane block performed before modified radical mastectomy for postoperative analgesia.
Eksperimentel: SPSIP Block
Patients will receive an ultrasound-guided serratus posterior superior intercostal plane (SPSIP) block before modified radical mastectomy for postoperative analgesia.
Procedure: Serratus Posterior Superior Intercostal Plane Block
Ultrasound-guided serratus posterior superior intercostal plane block performed before modified radical mastectomy for postoperative analgesia.

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Total Postoperative Opioid Consumption
Tidsramme: 24 hours after surgery
Total opioid consumption during the first 24 hours after modified radical mastectomy.
24 hours after surgery

Sekundære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Intraoperative Remifentanil Consumption
Tidsramme: During surgery
Total intraoperative remifentanil consumption will be recorded and compared between groups.
During surgery
Postoperative Pain Scores
Tidsramme: 0-24 hours after surgery
Postoperative pain intensity measured using the Numeric Rating Scale (NRS), ranging from 0 to 10, where 0 indicates no pain and 10 indicates the worst imaginable pain. Higher scores indicate worse pain.
0-24 hours after surgery
Compartmental Pain Scores Using Numeric Rating Scale
Tidsramme: 0-24 hours after surgery
Numeric Rating Scale (NRS) score (0-10 points) measured separately for axillary pain, anterolateral chest wall pain, and surgical drain insertion site pain. A score of 0 indicates no pain and 10 indicates the worst imaginable pain. Higher scores indicate greater pain intensity.
0-24 hours after surgery
Dermatomal Sensory Block Distribution
Tidsramme: 30 minutes after block performance
Number of dermatomes blocked, assessed by pinprick sensory testing 30 minutes after block performance. Higher values indicate wider sensory block distribution.
30 minutes after block performance
Quality of Recovery-15 Score
Tidsramme: 24 hours after surgery
Quality of Recovery-15 (QoR-15) questionnaire score ranging from 0 to 150, where higher scores indicate better postoperative recovery and patient satisfaction.
24 hours after surgery
Block- and Opioid-Related Complications
Tidsramme: 24 hours after surgery
Complications related to block performance and opioid use will be recorded.
24 hours after surgery

Samarbejdspartnere og efterforskere

Det er her, du vil finde personer og organisationer, der er involveret i denne undersøgelse.

Sponsor

Ferit Yetik

Samarbejdspartnere

Bursa City Hospital

Efterforskere

  • Ledende efterforsker: Mürsel Ekinci, MD, Bursa City Hospital
  • Studiestol: Yusuf Alan, MD, Bursa City Hospital

Datoer for undersøgelser

Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.

Studer store datoer

Studiestart (Faktiske)

19. juni 2026

Primær færdiggørelse (Anslået)

1. november 2026

Studieafslutning (Anslået)

1. november 2026

Datoer for studieregistrering

Først indsendt

12. juni 2026

Først indsendt, der opfyldte QC-kriterier

17. juni 2026

Først opslået (Faktiske)

22. juni 2026

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

24. juni 2026

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

19. juni 2026

Sidst verificeret

1. juni 2026

Mere information

Begreber relateret til denne undersøgelse

Nøgleord

Yderligere relevante MeSH-vilkår

Andre undersøgelses-id-numre

  • MRM-2025-KAEK47
  • 2025-KAEK-47 (Anden identifikator: Clinical Research Ethics Committee of University of Health Sciences Bursa Faculty of Medicine)

Plan for individuelle deltagerdata (IPD)

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