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Serratus Posterior Superior Intercostal Plane Block for Postoperative Analgesia in Mastectomy
Mastectomy and Axillary Dissection: Evaluation of the Effect of Serratus Posterior Superior Intercostal Plane Block on Postoperative Analgesia: A Multicenter, Randomized, Placebo-Controlled Trial
Studie Overzicht
Toestand
Conditie
Interventie / Behandeling
Gedetailleerde beschrijving
This study is a prospective, randomized, placebo-controlled, multicenter clinical trial designed to evaluate the analgesic efficacy of the serratus posterior superior intercostal plane (SPSIP) block in patients undergoing mastectomy with axillary lymph node dissection. Postoperative pain following breast surgery is often significant and may increase opioid consumption and related adverse effects, highlighting the need for effective regional anesthesia techniques.
The SPSIP block is a novel ultrasound-guided interfascial plane block with emerging evidence in thoracic and chest wall procedures; however, its role in breast surgery remains unclear, particularly in placebo-controlled settings. This study aims to determine whether the SPSIP block provides additional benefit as part of a standardized multimodal analgesia approach.
Participants will be randomly assigned to receive either SPSIP block with local anesthetic or a placebo intervention under identical conditions, with blinding applied to all relevant parties. All patients will receive the same perioperative anesthesia and analgesia protocol.
The results of this study are expected to clarify the clinical value of SPSIP block in breast surgery and contribute to the development of evidence-based postoperative pain management strategies.
Studietype
Inschrijving (Geschat)
Fase
- Niet toepasbaar
Contacten en locaties
Studiecontact
- Naam: Fatma Acil, M.D.
- Telefoonnummer: +905337225225
- E-mail: acilfatma@gmail.com
Studie Locaties
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Outside of the US
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Diyarbakır, Outside of the US, Turkije (Türkiye), 21070
- Werving
- Fatma Acil
-
Contact:
- Fatma Acil, M.D.
- Telefoonnummer: +905337225225
- E-mail: acilfatma@gmail.com
-
-
Deelname Criteria
Geschiktheidscriteria
Leeftijden die in aanmerking komen voor studie
- Volwassen
- Oudere volwassene
Accepteert gezonde vrijwilligers
Beschrijving
Inclusion Criteria:
- Female patients aged 18-65 years
- ASA physical status I-III
- Scheduled for elective unilateral mastectomy with axillary lymph node dissection under general anesthesia
- Able to understand and use the Numeric Rating Scale (NRS) for pain assessment
- Provided written informed consent
Exclusion Criteria:
- Known allergy or hypersensitivity to local anesthetics (e.g., bupivacaine)
- Coagulopathy, thrombocytopenia (<100,000/mm³), or ongoing anticoagulant/antiplatelet therapy that cannot be discontinued
- Infection or skin lesion at the injection site
- Planned bilateral surgery or additional major surgical procedures
- Chronic pain conditions or regular use of opioids, gabapentinoids, or centrally acting analgesics
- Neurological or psychiatric conditions interfering with pain assessment
- History of previous major thoracic or chest wall surgery on the same side
- Pregnancy or breastfeeding
- Refusal to participate or inability to provide informed consent
Studie plan
Hoe is de studie opgezet?
Ontwerpdetails
- Primair doel: Behandeling
- Toewijzing: Gerandomiseerd
- Interventioneel model: Parallelle opdracht
- Masker: Verviervoudigen
Wapens en interventies
Deelnemersgroep / Arm |
Interventie / Behandeling |
|---|---|
|
Placebo-vergelijker: Placebo Group
Participants in this group will receive an ultrasound-guided placebo block using 30 mL of normal saline under identical conditions, in addition to standard general anesthesia and multimodal analgesia.
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Participants will receive an ultrasound-guided SPSIP block using normal saline under identical conditions.
|
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Experimenteel: Serratus Posterior Superior Intercostal Plane Block Group
Participants in this group will receive an ultrasound-guided serratus posterior superior intercostal plane (SPSIP) block prior to surgery using 30 mL of 0.25% bupivacaine, in addition to standard general anesthesia and multimodal analgesia.
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Participants will receive an ultrasound-guided SPSIP block using bupivacaine.
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Wat meet het onderzoek?
Primaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
|---|---|---|
|
24-hour cumulative opioid consumption
Tijdsspanne: 24 hours
|
Total opioid consumption within the first 24 hours after surgery, recorded in milligrams.
|
24 hours
|
Secundaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
|---|---|---|
|
Static postoperative pain intensity at rest
Tijdsspanne: 0, 1, 2, 6, 12, and 24 hours after surgery
|
Postoperative pain intensity at rest will be assessed using the Numeric Rating Scale (NRS), ranging from 0 to 10, where 0 indicates no pain and 10 indicates the worst imaginable pain.
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0, 1, 2, 6, 12, and 24 hours after surgery
|
|
Dynamic postoperative pain intensity during movement
Tijdsspanne: 0, 1, 2, 6, 12, and 24 hours after surgery
|
Postoperative pain intensity during movement will be assessed using the Numeric Rating Scale (NRS), ranging from 0 to 10, where 0 indicates no pain and 10 indicates the worst imaginable pain.
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0, 1, 2, 6, 12, and 24 hours after surgery
|
|
Rescue analgesia requirement
Tijdsspanne: Within 24 hours after surgery
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Number of patients requiring rescue analgesia and total rescue analgesic consumption.
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Within 24 hours after surgery
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Time to first rescue analgesia
Tijdsspanne: Within 24 hours after surgery
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Time from the end of surgery to the first administration of rescue analgesia.
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Within 24 hours after surgery
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Incidence of postoperative nausea and vomiting (PONV)
Tijdsspanne: Within 24 hours after surgery
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Occurrence of nausea and/or vomiting during the postoperative period.
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Within 24 hours after surgery
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Block-related and opioid-related adverse events
Tijdsspanne: Within 24 hours after surgery
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Incidence of adverse events including local anesthetic toxicity, hematoma, infection, and opioid-related side effects.
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Within 24 hours after surgery
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Quality of Recovery-15 (QoR-15) score
Tijdsspanne: 24 hours after surgery
|
Quality of recovery assessed using the QoR-15 questionnaire.
Quality of Recovery-15 (QoR-15) questionnaire was used to assess postoperative recovery.
The total score ranges from a minimum of 0 to a maximum of 150.
A higher score represents a better recovery outcome (0 = extremely poor recovery, 150 = excellent recovery)
|
24 hours after surgery
|
Medewerkers en onderzoekers
Onderzoekers
- Hoofdonderzoeker: Fatma Acil, M.D., Saglik Bilimleri Universitesi Gazi Yasargil Training and Research Hospital
Studie record data
Bestudeer belangrijke data
Studie start (Werkelijk)
Primaire voltooiing (Geschat)
Studie voltooiing (Geschat)
Studieregistratiedata
Eerst ingediend
Eerst ingediend dat voldeed aan de QC-criteria
Eerst geplaatst (Werkelijk)
Updates van studierecords
Laatste update geplaatst (Werkelijk)
Laatste update ingediend die voldeed aan QC-criteria
Laatst geverifieerd
Meer informatie
Termen gerelateerd aan deze studie
Trefwoorden
Aanvullende relevante MeSH-voorwaarden
Andere studie-ID-nummers
- 27/01/2026-38
Plan Individuele Deelnemersgegevens (IPD)
Bent u van plan om gegevens van individuele deelnemers (IPD) te delen?
Beschrijving IPD-plan
IPD-tijdsbestek voor delen
IPD-toegangscriteria voor delen
IPD delen Ondersteunend informatietype
- LEERPROTOCOOL
- ICF
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