Comparison of Erector Spinae Plane Block and Serratus Posterior Superior Intercostal Plane Block

Diskapi Yildirim Beyazit Training and Research Hospital

Status: Completed

Conditions: Postoperative Pain; Erector Spinae Plane Block; Breast Neoplasms; Serratus Posterior Superior Intercostal Plane Block; Acute Pain

Treatments: Procedure: Serratus Posterior Superior Intercostal Plane Block; Procedure: Erector Spinae Plane Block

Study type: Interventional

Funder types: Other

Identifiers

NCT06407037

AEŞH-EK1-2023-824

Details and patient eligibility

About

Breast cancer is the most common malignancy in women. Modified radical mastectomy, a surgical procedure in the treatment of breast cancer, is one of the standard treatments. Postoperative pain can seriously reduce the quality of life in patients, and inadequately treated acute pain can trigger chronic pain syndrome. Therefore, thoracic paravertebral block and thoracic epidural block are effective in postoperative analgesia. However, the use of these blocks is limited due to complications. In recent years, less invasive blocks, such as pectoral nerve block (PECS I-II), Serratus anterior plane block (SAPB), Erector spinae plane block (ESPB), and Serratus Posterior Superior intercostal Plane Block (SPSİPB) have been applied. In this study, it was aimed to compare the analgesic effectiveness of ESPB and SPSİPB applications in patients undergoing breast surgery.

Full description

Postoperative pain will be assessed during resting and coughing with a visual analog scale (0-10 cm) and nausea and vomiting with a Postoperative Nausea Vomiting Score at the postoperative 1, 4, 8, 12, and 24 hours. The amount of tramadol consumed in the postoperative period will be recorded. Patient satisfaction will be assessed with the Likert scale at postoperative 24 hours.

Enrollment: 50 patients

Sex: Female

Ages: 18 to 65 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Those aged 18-65
• Those with ASA scores I-II-III
• Those with a body mass index (BMI) between 18-35
• Patients who will undergo breast surgery

Exclusion criteria

• Those under the age of 18 and over the age of 65
• Those with ASA score IV and above
• Those with a history of allergy to the drugs to be blocked
• Those with a history of bleeding diathesis
• Patients with infection in the area to be blocked
• Those with a BMI below 18 and above 35
• Patients who underwent surgery under emergency conditions

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Quadruple Blind

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50 participants in 2 patient groups

Erector Spinae Plane Block

Active Comparator group

Description:

Following the visualization of the anatomical structures, the nerve block needle was advanced via the in-plane technique beneath the erector spinae muscles until the interfascial space was reached. After hydrodissection with 2 ml normal saline, 30 ml of 0.25% bupivacaine was injected into the area.

Treatment:

Procedure: Erector Spinae Plane Block

Serratus Posterior Superior Intercostal Plane Block

Active Comparator group

Description:

The probe was placed on the spinae scapula in the sagittal plane to identify the second and third ribs. The trapezius, rhomboid, serratus posterior superior muscle were visualized. The needle was inserted just above the third rib deeply into the serratus posterior superior muscle. Two mL isotonic was administrated for the correction. Then, 30 mL of 0.25% bupivacaine was administrated between serratus posterior superior muscle and rib.

Treatment:

Procedure: Serratus Posterior Superior Intercostal Plane Block