Serratus Posterior Superior vs Erector Spinae Plane Block for Breast Surgery

Postoperative pain after mastectomy remains a significant clinical problem that may impair patient comfort and delay early rehabilitation, potentially affecting functional recovery. Various analgesic techniques are used to manage postoperative pain. This study aims to compare serratus posterior superior intercostal plane block and erector spinae plane block, which are routinely used in our clinic for postoperative analgesia in patients undergoing mastectomy, in terms of ease of application and patient comfort.

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Key information

Conditions

Postoperative Pain Neurologic Manifestations Pain Pain, Postoperative Pathologic Processes Pathological Conditions, Signs and Symptoms Postoperative Complications Signs and Symptoms

Age range

25 year–65 year

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

About this study

Postoperative pain following mastectomy is a common and clinically significant issue that not only reduces patient comfort but may also hinder early mobilization and rehabilitation, thereby negatively impacting overall functional outcomes. Effective postoperative analgesia is therefore a key component of perioperative care in breast surgery.

A variety of analgesic techniques, including systemic analgesics and regional anesthesia methods, are currently employed to manage postoperative pain. Among these, ultrasound-guided fascial plane blocks have gained increasing popularity due to their relative safety, simplicity, and effectiveness. The serratus posterior superior intercostal plane (SPSIP) block and the erector spinae plane (ESP) block are two such regional techniques used for thoracic analgesia.

In our clinical practice, both SPSIP and ESP blocks are routinely used for patients undergoing mastectomy. However, comparative data regarding their ease of application and impact on patient comfort are limited. Ease of application is an important consideration for anesthesiologists, particularly in busy clinical settings, while patient comfort during block placement is a critical but often underreported outcome.

The primary aim of this study is to compare SPSIP block and ESP block in patients undergoing mastectomy in terms of ease of application and patient comfort during the procedure. Secondary considerations may include block-related characteristics and their contribution to postoperative recovery.

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

Patients aged 25-65 years American Society of Anesthesiologists (ASA) physical status I-III Patients scheduled for mastectomy under general anesthesia Patients with no history of previous breast surgery Patients who provide written informed consent to participate in the study

Exclusion criteria

ASA physical status IV and above History of alcohol or substance abuse Known allergy to local anesthetics or opioids Patients with severe psychiatric disorders Patients who refuse to participate or do not provide informed consent

Treatment and study plan

Serratus Posterior Superior Intercostal Plane Block

Procedure

Participants in this group will receive an ultrasound-guided serratus posterior superior intercostal plane (SPSIP) block for postoperative analgesia following mastectomy. The block will be performed under standardized conditions prior to surgery according to the study protocol.

Erector Spinae Plane Block

Procedure

Participants in this group will receive an ultrasound-guided erector spinae plane (ESP) block for postoperative analgesia following mastectomy. The block will be performed under standardized conditions prior to surgery according to the study protocol.

Primary outcomes

Ease of block application (procedure difficulty score)

Time frame: Immediately after block performance

The ease of application of the block will be evaluated using a 10-point numerical rating scale (0-10), where lower scores indicate easier application and higher scores indicate greater procedural difficulty. The score will be assigned by the anesthesiologist performing the block immediately after completion of the procedure.

Secondary outcomes

Postoperative pain score at 24 hours

Time frame: 24 hours postoperatively

Postoperative pain intensity will be assessed using a 10-cm Visual Analog Scale (0 = no pain, 10 = worst imaginable pain) at 24 hours after surgery.
Quality of recovery at 24 hours

Time frame: 24 hours postoperatively

Postoperative recovery quality will be assessed using the Quality of recovery (QoR-15) questionnaire at 24 hours after surgery. The total score ranges from 0 to 150, with higher scores indicating better recovery.

Sponsors and collaborators

Lead sponsor

Sakarya University

Other

Registry information

Official study title

Comparison of Serratus Posterior Superior Intercostal Plane Block and Erector Spinae Plane Block in Breast Surgery in Terms of Ease of Application and Patient Comfort

Important dates

Study start: 2026
Primary completion: 2026
Study completion: 2026
First posted: May 1, 2026
Registry last updated: May 1, 2026

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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