Comparison of Postoperative Analgesic Efficacy of Two Different Blocks in Modified Radical Mastectomy Surgery

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Conditions studied: Breast Cancer, Postoperative Pain

In brief

Postoperative pain following modified radical mastectomy remains a significant clinical challenge and may delay recovery, impair patient comfort, and increase opioid consumption. Ultrasound-guided fascial plane blocks have become an important component of multimodal analgesia for breast surgery. The serratus anterior plane block (SAPB) is an established regional anesthesia technique that provides effective postoperative analgesia. The serratus posterior superior intercostal plane block (SPSIPB) is a recently described interfascial block with promising analgesic effects, but evidence comparing its efficacy with SAPB in breast surgery remains limited. This prospective, randomized, double-blind, single-center clinical trial aims to compare the postoperative analgesic efficacy of ultrasound-guided SPSIPB and SAPB in patients undergoing modified radical mastectomy under general anesthesia. Seventy female patients aged 18-65 years with American Society of Anesthesiologists (ASA) physical status I-III will be randomly assigned to receive either SPSIPB or SAPB before surgery. The primary outcome is postoperative pain intensity assessed using the Visual Analog Scale (VAS). Secondary outcomes include intraoperative remifentanil consumption, cumulative tramadol consumption during the first 24 postoperative hours, postoperative nausea and vomiting (PONV), quality of recovery assessed with the QoR-40 questionnaire, rescue analgesic requirements, and block-related complications. The findings of this study are expected to provide evidence regarding the comparative effectiveness and safety of these two interfascial plane blocks for postoperative analgesia in breast cancer surgery.

Key facts

Study ID

NCT07737132

Run by

Sultan Abdulhamid Han Training and Research Hospital, Istanbul, Turkey

People needed

70

Starts

2026-08-01

Expected to finish

2027-03-01

Last updated by the study team

2026-07-30

Who can join

Age: 18 and older, up to 65. Sex: female. Healthy volunteers: not accepted.

You may qualify if…

• Female patients aged 18 to 65 years.
• Scheduled for elective modified radical mastectomy under general anesthesia.
• American Society of Anesthesiologists (ASA) physical status I-III.
• Body mass index (BMI) <35 kg/m².
• Normal coagulation profile (including INR and platelet count).
• Normal liver and renal function tests.
• Able to understand the study procedures and provide written informed consent.

You may not qualify if…

• Known allergy or hypersensitivity to local anesthetics.
• Coagulation disorders or bleeding diathesis.
• Infection or inflammation at the planned block site.
• ASA physical status IV or higher.
• Chronic opioid use or chronic pain requiring long-term analgesic therapy.
• Advanced hepatic or renal insufficiency.
• Severe pulmonary disease.
• Opioid use within 24 hours before surgery.
• Cognitive impairment or inability to complete postoperative assessments.
• Revision breast surgery.
• Refusal to participate in the study.

Full record on ClinicalTrials.gov

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