What type of study is this?

This is a Human Clinical Trial study (also classified as: RCT).

What question did this study set out to answer?

This trial compares the efficacy of intertransverse process block and erector spinae plane block in combination with interpectoral block for breast cancer surgery.

February 26, 2026Open Access

Intertransverse Process Block versus Erector Spinae Plane Block as Adjuncts to an Interpectoral Block for Breast Cancer Surgery: A Randomized Controlled Trial

Key Points

This trial compares the efficacy of intertransverse process block and erector spinae plane block in combination with interpectoral block for breast cancer surgery.
Randomized controlled trial with 90 patients.
Compared intertransverse process block with erector spinae plane block combined with interpectoral block under general anesthesia.
Measured primary outcome of 24-hour morphine consumption and secondary outcomes of intraoperative fentanyl use and NRS pain scores.
Median morphine use was significantly lower in both intervention groups compared to the control group.
Both blocks reduced NRS pain scores by approximately 1-1.2 points compared to control.
ITPB required more performance time than ESPB.

Abstract

Purpose: This trial compared the efficacy of intertransverse process block (ITPB) with erector spinae plane block (ESPB), each in combination with an interpectoral block (IPB), with systemic analgesia for breast cancer surgery. Patients and Methods: Ninety patients were randomized to ITPB/IPB, ESPB/IPB, or control under general anesthesia. The primary outcome was 24-hour morphine consumption. Secondary outcomes included intraoperative fentanyl use, numeric rating scale (NRS) pain scores, and recovery parameters. A 40% reduction in morphine consumption and a 2-point NRS decrease were prespecified as minimal clinically important differences (MCIDs). The IPB was applied equally in both intervention groups to reduce pectoral nerve-mediated pain. Results: Median (IQR) 24-hour morphine use was 0 mg (0– 6), 3 mg (0– 4), and 6 mg (3– 6) in the ITPB/IPB, ESPB/IPB, and control groups, respectively. Morphine consumption did not differ between the ITPB/IPB and ESPB/IPB (median difference 0 mg; 95% CI 0 to 1; p = 0.275) but was lower in both groups compared with the control group (− 2.5 mg; 95% CI − 4 to 0; p = 0.014 and − 2.7 mg; 95% CI − 3 to 0; p = 0.003), exceeding the MCID despite modest absolute differences. Mean NRS pain scores were lower in both block groups than in the control group by approximately 1– 1.2 points across the postoperative period. Intraoperative fentanyl use and time to ambulation were significantly reduced in both groups compared with the control. ITPB required longer performance time (+3.4 minutes; 95% CI 1.9 to 5.0; p < 0.001). Conclusion: Both ITPB/IPB and ESPB/IPB provided comparable and effective analgesia after breast cancer surgery. Given its shorter performance time, ESPB may be the more practical option. However, because the IPB constituted a shared analgesic component in both groups, the independent analgesic effects of ITPB and ESPB remain uncertain and warrant further investigation. Keywords: analgesia, anesthesia, local, pain, postoperative, regional anesthesia

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Cite This Study

Samerchua et al. (Sun,) studied this question.

synapsesocial.com/papers/699f95a81bc9fecf3dab39cc https://doi.org/https://doi.org/10.2147/jpr.s579089

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