Investigation of the Effects of Serratus Posterior Superior Intercostal Plane Block and Serratus Anterior Plane Block on Perioperative Analgesia Management in Patients Scheduled for Mastectomy
Mastektomi Planlanan Hastalarda Serratus Posterior Superior İnterkostal Plan Bloğu Ile Serratus Anterior Plan Bloğunun Peroperatif Analjezi Yönetimi Üzerine Etkilerinin Araştırılması
Uludag University
66 participants
Oct 15, 2025
INTERVENTIONAL
Conditions
Summary
This study aims to evaluate and compare the analgesic efficacy of two ultrasound-guided regional anesthesia techniques, the serratus anterior plane (SAP) block and the serratus posterior superior intercostal plane (SPSIP) block, in patients undergoing elective mastectomy surgery. Postoperative pain following mastectomy is a common and significant clinical problem that negatively affects patient comfort, delays mobilization, and may prolong hospital stay. Although systemic analgesics are commonly used, they are associated with adverse effects such as sedation, constipation, and potential dependency. In this randomized clinical study, female patients aged 18-75 years with ASA physical status I-III scheduled for elective mastectomy will be included after obtaining informed consent. Patients will be allocated into two groups to receive either SAP block or SPSIP block under ultrasound guidance prior to surgery. Standardized general anesthesia and perioperative analgesia protocols will be applied to all patients. The primary objective is to compare postoperative pain scores between the two groups using the Numeric Rating Scale (NRS). Secondary outcomes include time to first analgesic requirement, total analgesic consumption, intraoperative opioid use, and hemodynamic parameters. By comparing these two interfascial plane blocks, this study aims to identify a more effective analgesic technique that improves postoperative pain control, enhances patient comfort, and facilitates early mobilization following mastectomy.
Eligibility
Inclusion Criteria4
- Female patients aged between 18 and 75 years
- Patients scheduled for elective mastectomy surgery
- American Society of Anesthesiologists (ASA) physical status I-III
- Patients who provide written informed consent
Exclusion Criteria10
- Patients who refuse to participate in the study
- Patients with American Society of Anesthesiologists (ASA) physical status IV or V
- Patients receiving anticoagulant therapy or with suspected coagulopathy
- Patients with known allergy to local anesthetic agents
- Infection at the site of block application
- Pregnant patients or those with suspected pregnancy
- Patients with severe neurological or psychiatric disorders
- Patients with severe cardiovascular disease
- Patients with chronic opioid use
- Patients with hepatic failure or renal failure (glomerular filtration rate \<15 mL/min/1.73 m²)
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Interventions
Under ultrasound guidance with a linear probe, the needle is inserted along the posterior axillary line between the second and seventh ribs and advanced into the plane between the serratus anterior muscle and the rib surface. A total of 30 mL of 0.25% bupivacaine (maximum dose 2 mg/kg/day) is injected.
Under ultrasound guidance with a linear probe, the superomedial border of the scapula on the operative side is identified. The needle is inserted medial to the scapula between the second and seventh ribs and advanced into the interfascial plane between the serratus posterior superior muscle and the intercostal muscles. Subsequently, 30 mL of 0.25% bupivacaine (maximum dose 2 mg/kg/day) is administered.
Locations(1)
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NCT07510269