What question did this study set out to answer?

This research aims to evaluate the effectiveness of serratus plane blocks versus conventional analgesia in managing postoperative pain for breast cancer surgery.

May 15, 2026Open Access

Serratus Posterior Superior Intercostal Plane Block and Serratus Anterior Plane Block Compared with Conventional Analgesia for Postoperative Analgesia in Breast Cancer Surgery: A Randomized Controlled Trial

Key Points

This research aims to evaluate the effectiveness of serratus plane blocks versus conventional analgesia in managing postoperative pain for breast cancer surgery.
Prospective randomized controlled trial with 105 patients aged 18–65 years, ASA I-III.
Patients were randomized into three groups: Control, SPSIPB, and SAPB, with blinded outcome assessors.
Primary outcome measured was cumulative tramadol consumption; secondary outcomes included pain and recovery quality assessments.
SPSIPB and SAPB groups had significantly lower cumulative tramadol use in the first 24 hours (p < 0.001) compared to the Control Group.
No significant differences in Numeric Rating Scale pain scores among groups but higher Quality of Recovery-15 scores in SPSIPB and SAPB groups.
Lower antiemetic requirements in both serratus block groups versus Control.

Abstract

Purpose: The aim of this study was to compare the analgesic efficacy and recovery outcomes of the serratus posterior superior intercostal plane block (SPSIPB) and the serratus anterior plane block (SAPB) with conventional analgesia in patients undergoing oncoplastic breast surgery. Patients and Methods: One hundred and five patients aged 18– 65 years with an ASA physical status of I–III were included in this prospective, randomized controlled study. Patients were randomly assigned in a 1:1:1 ratio to three groups: the Control Group, the SPSIPB Group, and the SAPB Group. Outcome assessors were blinded to group allocation. The primary outcome was cumulative tramadol consumption during the first 24 h postoperative. Secondary outcomes included Numeric Rating Scale (NRS) scores at rest and during activity, Quality of Recovery-15 (QoR-15) scores, and the incidence of postoperative nausea and vomiting (PONV). Results: Cumulative tramadol consumption during the first 24 h was significantly lower in the SPSIPB and SAPB groups compared with the Control Group (p < 0.001), with no significant difference between the two block groups. Although NRS pain scores were comparable among groups at all time points, QoR-15 scores were significantly higher and antiemetic requirements were lower in both block groups compared with the Control Group. Conclusion: The SPSIPB and SAPB reduced opioid consumption and improved quality of recovery compared with conventional management, despite similar pain scores, with no significant difference between the two techniques. Keywords: breast surgery, postoperative pain management, opioid consumption, regional anesthesia

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